Topics Related to Hospital Providers
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation
Billing Requirements for Medicaid Direct Providers
Coverage Effective Nov. 1, 2023.
Hospital at Home Program Re-Launch: NC Medicaid will cover the Acute Hospital at Home Program starting Nov. 1, 2023.
NOTE: This Bulletin was revised on April 2, 2024 to correct an error. In the original version, published Sept. 27, 2023, it was stated that the Hospital at Home Program had a previous end date of March 31, 2021. Prior to relaunch, the previous end date was March 31, 2022, as corrected and explained below.
NOTE: This Bulletin was revised on April 2, 2024 to correct an error. In the original version, published Sept. 27, 2023, it was stated that the Hospital at Home Program had a previous end date of March 31, 2021. Prior to relaunch, the previous end date was March 31, 2022, as corrected and explained below.
In compliance with federal requirements, beneficiary consent is required for all voluntary sterilizations.
Flexibilities ending at or after the end of the Federal Public Health Emergency
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.
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.
For clarification purposes of information communicated in October 2018 Medicaid Bulletin, please note that effective Oct. 1, 2018 the new 4-digit Long Acting Reversible Contraceptives (LARC) DRG code is not required to be submitted on the claim.
For Inpatient Hospital services the appropriate reimbursement process will begin after the claim has been grouped using the Grouper Software as usual. Either the original maternity DRG, or the LARC will be assigned systematically.
For Inpatient Hospital services the appropriate reimbursement process will begin after the claim has been grouped using the Grouper Software as usual. Either the original maternity DRG, or the LARC will be assigned systematically.
Additional information on prior authorization is available.