Public Comments Requested by May 30, 2025.
Topics Related to Medicaid Direct
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.
NC Medicaid’s Electronic Visit Verification (EVV) system for Home Health ensures compliance with federal requirements
This corrects the end-date for code G9920 in the December 2024 bulletin.
The Centers for Medicare & Medicaid Services (CMS) is implementing 50 new procedure codes effective April 1, 2025.
The Centers for Medicare & Medicaid Services has extended this service through March 31, 2025
Coverage has been restored to definitive drug testing codes that exceed seven drug classes retroactive to Dec. 1, 2024.
Use Standard Plan and Tailored Plan provider portals or Real-Time Eligibility Electronic Data Interchange Transactions 270/271.
An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of March 1, 2025, was posted to the NC Medicaid Clinical Coverage Policy web page.Summary of UpdatesIn the table Related Clinical Coverage Policies, added reference to clinical coverage policy 3D, Hospice Services.The terms ‘approval,’ ‘authorization’ and ‘prior authorization’ were changed to ‘prior approval’ for consistency throughout.