Effective Oct. 22, 2021, NC Medicaid-enrolled providers can bill code 99401 with HM modifier for telephone outreach to unvaccinated Medicaid beneficiaries.
Topics Related to COVID-19
In response to the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective Aug. 1, 2020.
The prior authorization waiver is extended to Oct. 15.
NC Medicaid is updating the special focused financial assistance to Skilled Nursing Facilities provided through outbreak rates.
NC Medicaid reimburses for the provision of the vaccine at the same rate as Medicare and is creating an additional payment to encourage access to vaccines during the Public Health Emergency.
Effective June 8, 2021, Medicaid will pay an extra $35, in addition to the standard administration payment (approximately $40 per COVID-19 vaccine dose), for a total payment of approximately $75 for a vaccine dose administered in a patient's home.
Effective Sept. 1, 2021, the Acute Hospital Care at Home (HAH) program will be available to North Carolina hospitals that have been granted a waiver from CMS and service NC Medicaid beneficiaries. NC Medicaid is planning to implement this program to be effective Sept. 1 through Dec. 31, 2021, unless this flexibility is terminated prior to Dec. 31, 2021.
Due to the rapid increase in COVID infection and related hospitalization occupancy, NC Medicaid is reactivating its consideration of Response Facility Designation Requests submitted by skilled nursing facilities.
NC Medicaid licensed pharmacists are authorized to order and administer REGEN-COV monoclonal antibodies and pharmacy technicians/interns may administer it, in accordance with the conditions of their licensure and/or scope of practice.
NC Medicaid is extending all current COVID-19 temporary provider rate increases through Nov. 30, 2021. While the rate increases for providers authorized under SL 2020-4 were set to expire on June 30, 2021, NC Medicaid has discretion to continue these and other temporary rate increases assuming budget availability.