Topics Related to Medicaid Managed Care
NC Medicaid has released a new online tool for beneficiaries to compare the five available Standard Plans. The 2025 NC Medicaid Standard Plan Performance Comparison Tool is now available online.
Providers can continue billing Diagnosis Related Group claims using revenue code 0161 for room and board and occurrence span code 82.
Temporary flexibilities to the Innovations Waiver after Hurricane Helene are ending July 1, 2025.
The Centers for Medicare & Medicaid Services (CMS) requires individuals in the NC Medicaid Innovations waiver program to have a valid and comprehensive assessment.
NC Medicaid’s Electronic Visit Verification (EVV) system for Home Health ensures compliance with federal requirements.
Care Management rate considerations effective July 1, 2025.
Reminder: NC Medicaid does not require Carolina Access/Advanced Medical Home referrals for specialty care.
Individual provider enrollment and Additional Managed Care Options
Policy is updated effective May 1, 2025
Public Comments Requested by May 30, 2025.