Providers can continue billing Diagnosis Related Group claims using revenue code 0161 for room and board and occurrence span code 82.
Topics Related to Medicaid Direct
Temporary flexibilities to the Innovations Waiver after Hurricane Helene are ending July 1, 2025.
The Centers for Medicare & Medicaid Services (CMS) requires individuals in the NC Medicaid Innovations waiver program to have a valid and comprehensive assessment.
NC Medicaid’s Electronic Visit Verification (EVV) system for Home Health ensures compliance with federal requirements.
Reminder: NC Medicaid does not require Carolina Access/Advanced Medical Home referrals for specialty care.
Individual provider enrollment and Additional Managed Care Options
Policy is updated effective May 1, 2025
Public Comments Requested by May 30, 2025.
NC Medicaid’s Electronic Visit Verification (EVV) vendor, Sandata, will implement multi-factor authentication process for those accessing Sandata EVV and the Aggregator portals.
The Per Diem Rate Methodology for Congregate Settings effective April 1, 2025.