Effective Aug. 1, 2024, Medicaid will require a primary diagnosis of spinal subluxation for NC Medicaid Direct claims.
Topics Related to Medicaid Direct
Standard Plans will begin to reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
Effective Aug. 1, 2024, NC Medicaid will cover obesity management medications for beneficiaries 12 years of age and older.
Effective Aug. 1, 2024, over the counter oral contraceptive Opill will be available without a prescription, at no cost.
Effective Dec. 1, 2023, updates increased treatment visit limits for beneficiaries aged 21 and older. The home health ordering practitioner reference was also updated.
Effective June 1, 2024, CPT codes are newly eligible for coverage.
Effective retroactive to April 1, 2023, Z31.430 and Z31.440 will be covered diagnosis codes in NCTracks.
Provider Data Management / Credentialing Verification Organization (PDM/CVO) Solution New Launch Date of 2026.
Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.
Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation