Topics Related to Medicaid Managed Care
Assessment rates were affected by the implementation and subsequent reversal of the Oct. 1, 2025, per diem rate reductions.
Flexibilities effective Jan. 23, 2026, to Jan. 26, 2026, for NC Medicaid beneficiaries due to Winter Storm.
Promulgation of New Clinical Coverage Policies and Amendment to Clinical Coverage Policy 8A Enhanced Mental Health and Substance Abuse Services.
Effective Jan. 1, 2026, The Acute Inpatient Hospital Services policy has been revised.
Coverage for Healthcare Common Procedure Coding System Code G0512 is end-dating effective Dec. 31, 2025.
Clinical Coverage Policy 1S-11 will include coverage for AlloMap® effective Jan. 1, 2026.
This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care.
Effective Dec. 12, 2025, coverage for GLP-1s for the treatment of obesity will be reverted to the coverage available as of Sept. 30, 2025.
This announcement is for NC Medicaid and Division of Mental Health, Developmental Disabilities, and Substance Use Services State Funded Behavioral Health Providers.
The new NC Medicaid Mental Health Parity website provides information on NC Medicaid compliance with federal mental health parity requirements.