Topics Related to Behavioral Health Providers

June 30, 2021, is the implementation date of Electronic Visit Verification (EVV) for the Innovations waiver, Traumatic Brain Injury (TBI) waiver and (b)(3) services administered by the LME/MCOs.

NC Medicaid has published updated guidance on Tailored Care Management, including updates on Advanced Medical Home + (AMH+)/Care Management Agency (CMA) Certification, capacity building and rates.

The Department is releasing the draft Tailored Care Management Desk Review Guide and Scoring Tool to support providers applying for AMH+ or Care Management Agency certification. 

Effective July 1, 2021, NC Medicaid will increase fee-for-service rates and establish rate floors for facility-based crisis and mobile crisis management services that will mandate minimum reimbursement rates.

Clinical Coverage Policy 1A-41, Office-Based Opioid Treatment is being updated to add buprenorphine for the treatment of patients aged 16 years and older.

DHHS is releasing an addendum to the Tailored Care Management Provider Manual on community inclusion that addresses the in-reach and transition requirements for Advanced Medical Home Plus practices and Care Management Agencies delivering Tailored Care Management.

The implementation date of Electronic Visit Verification for LME-MCOs has been extended to June 30, 2021.

NC Medicaid has updated its Appendix K to extend flexibilities on how Medicaid providers and beneficiaries access and receive home- and community-based services through CAP/C, CAP/DA, NC Innovations waiver and Traumatic Brain Injury waiver. 

To continue supporting providers interested in obtaining certification as an Advanced Medical Home Plus (AMH+) practice or Care Management Agency (CMA), the Round 1 application deadline is being extended from March 1, 2021 to June 1, 2021.

This bulletin informs LME-MCOs and providers about the amendments made to providers types eligible to bill the Screening, Brief Intervention and Referral to Treatment (SBIRT) CPT codes effective as of March 1, 2021.