Topics Related to Doctors (DO, DC, MD and DPM)

Effective with date of service December 1, 2017, the North Carolina Medicaid and NC Health Choice (NCHC) programs cover vestronidase alfa-vjbk injection, for intravenous use (Mepsevii) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3590 – Unclassified biologics.

Effective with date of service Jan. 8, 2018, the North Carolina Medicaid and NC Health Choice (NCHC) programs covers hepatitis B vaccine (recombinant), adjuvanted solution for intramuscular injection (Heplisav-B) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code 90739 - Hepatitis B vaccine (HepB), adult dosage, two dose schedule, for intramuscular use.

Effective with date of service Jan. 4, 2018, the North Carolina Medicaid and NC Health Choice (NCHC) programs cover etelcalcetide injection, for intravenous use (Parsabiv) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J0606 - Injection, etelcalcetide, 0.1 mg.

Effective with date of service Dec. 11, 2107, the North Carolina Medicaid and NC Health Choice (NCHC) programs cover letermovir injection (Prevymis) for intravenous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective with date of service March 1, 2018, North Carolina Medicaid and NC Health Choice (NCHC) programs cover buprenorphine extended-release injection (Sublocade), for subcutaneous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective Jan. 4, 2018, the North Carolina Medicaid and NC Health Choice (NCHC) programs will cover aprepitant injectable emulsion (Cinvanti), for intravenous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective with date of service, June 1, 2016, the North Carolina Medicaid program covers Axumin for use in the Physician’s Drug Program (PDP) when billed with HCPCS code A4641, radiopharmaceutical, diagnostic, not otherwise classified.

Effective with date of Service Jan. 1, 2018, the North Carolina Medicaid and NC Health Choice programs cover treprostinil injection (Remodulin), for subcutaneous infusion or intravenous infusion in the Physician’s Drug Program when billed with HCPCS code J3285 - Injection, treprostinil, 1 mg.

Effective with date of service Nov. 27, 2017, the North Carolina Medicaid and NC Health Choice (NCHC) Program covers emicizumab-kxwh injection (Hemlibra), for subcutaneous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3590 - Unclassified biologics.

Effective with date of service Nov. 8, 2017, the North Carolina Medicaid program covers zoster vaccine recombinant, adjuvanted, suspension for intramuscular injection (Shingrix) for use in the Physician’s Drug Program (PDP) when billed with CPT code 90750 - Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection.