NC Medicaid is aware of challenges and concerns from retro-enrollment changes, particularly their impact on claims and recoupments.
Topics Related to Medicaid Direct
NC Medicaid updates mental health and substance use disorder policies.
Effective Feb. 1, 2025, Clinical Coverage Policy 10A services for beneficiaries aged 21 and older may be provided by independent practitioner providers.
Updates to NCTracks Third Party Liability process for NC Medicaid Direct.
Information session scheduled for Jan. 15, 2025.
Effective Feb. 1, 2025, updated unit limitations will be applied to some allergy testing and immunotherapy CPT codes.
Providers will continue to follow Personal Care Services in In-home settings (3L) from Jan. 1, 2025, through March 31, 2025.
The implementation of the Rate Reimbursement Methodology for individuals living in congregate settings will take effect on April 1, 2025.
Effective with date of service Jan. 1, 2025, new CPT codes have been added, some end-dated, and descriptions of some existing codes have been updated
Effective Jan. 1, 2025, NC Medicaid will cover U.S. Food & Drug Administration approved cell and gene therapies