NC Medicaid has temporarily modified the delivery of specific optical and hearing aid services to reduce in-person visits for Medicaid and NC Health Choice beneficiaries due to the state of emergency related to COVID-19. These temporary changes are retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when these modifications are rescinded. When the temporary modifications end, all face-to-face service requirements resume.
Topics Related to COVID-19
Note: SPECIAL BULLETIN COVID-19 #39 replaces SPECIAL BULLETIN COVID-19 #8: Face-to-Face Provider Site Visits and Fingerprinting Requirements Temporarily Suspended Due to COVID-19 Outbreak. Changes to the prior Bulletin are:
Current Policy: Private Duty Nursing (PDN) Clinical Coverage Policy 3G-1. Private Duty Nursing for Beneficiaries Age 21 and older and Private Duty Nursing (PDN) Clinical Coverage Policy 3G-2 Private Duty Nursing for Beneficiaries Age Under 21 years of age section 5.2.4.1:
(d) If services are terminated as a result of the beneficiary’s loss of Medicaid, or if no PDN services are provided during the 30 consecutive days for any reason such as a hospitalization, then the prior approval process must be initiated once again as outlined in Subsections 5.1 and 5.2.
DHHS and Community Care of North Carolina (CCNC) have launched a toll-free Patient Information and Support Line aimed at helping health care providers answer their patients' questions related to COVID-19. Their goal is to relieve some of the tremendous strain the pandemic is putting on health care providers and their staff.
The new helpline is called COVID-19 Triage Plus. Health care providers can recommend their patients call 1-877-490-6642 for assistance from nurse care managers who can help patients with:
SPECIAL BULLETIN COVID-19 #36 replaces in its entirety SPECIAL BULLETIN COVID-19 #21: Telehealth Provisions - Outpatient Specialized Therapies and Dental Services. Changes are to F. Place of Service for Outpatient Specialized Therapy and for Dental Services, and includes new teledentistry codes and guidance.
SPECIAL BULLETIN COVID-19 #35 replaces in its entirety SPECIAL BULLETIN #20 – Enhanced Behavioral Services.
SPECIAL BULLETIN COVID-19 #34 replaces the following Medicaid Bulletins in their entirety: SPECIAL BULLETIN COVID-19 #9: Telehealth Provisions – Clinical Policy Modification; SPECIAL BULLETIN COVID-19 #19: Telehealth Provisions – Clinical Policy Modification and SPECIAL BULLETIN COVID-19 #28: [ADDENDUM to Bulletin #9 Effective March 20, 2020] : Telehealth Provisions – Clinical Policy Modification. New telehealth codes, F. Place of Service change and a clarification to "psychologists" are included.
NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries receive Medicaid services in the wake of COVID-19. Utilization and prior approval limits for specific State Plan Medicaid services will be relaxed for all Medicaid beneficiaries impacted by COVID-19 including individuals participating in the NC Innovations Waiver and the NC TBI Waiver. Medicaid is hosting two webinars to further discuss the flexibilities.
Effective March 10, 2020, the Division of Health Benefits (DHB) implemented a 5% rate increase for certain Medicaid provider groups listed in the Bulletin. DHB will systematically reprocess claims submitted with dates of service beginning March 10, 2020, through the implementation date of the rate increase.
*This Bulletin has been updated in SPECIAL BULLETIN COVID-19 #175: Updated Guidance for Non-Emergency Medical Transportation - Aug. 19, 2021
“NC Medicaid COVID-19 Updated Guidelines for Non-emergency Medical Transportation (NEMT)” provides information to local Departments of Social Services (DSS) and NEMT providers on personal protective equipment (PPE).