Topics Related to Medicaid Managed Care

The 2025 ICD-10 update is effective Oct. 1, 2024, through Sept. 30, 2025, for provider use for dates of service within this period.
Guidance based on products approved by the FDA and recommended by the CDC Advisory Committee on Immunization Practices (ACIP).
Coverage effective for dates of service from July 26, 2024
Updates for providers on 1915(b)(3) services ending, new 1915(i) assessment tool and 1915(i) reassessments.
Information to share with beneficiaries to increase participation
Effective Sept. 1, 2024, NC Medicaid will begin covering condoms and spermicides as over-the-counter products, through the pharmacy benefit.
Hardship advances may be available for those at risk of not meeting financial obligations
Effective Sept. 1, 2024, hospital OST claims submitted to NCTracks must include the individual OPR NPI.