Topics Related to Orthotics and Prosthetics Providers
Recent court rulings now require the North Carolina Department of Health and Human Services to reverse provider rate reductions and restore rates to their Sept. 30, 2025, levels.
An amended version of Clinical Coverage Policy 5B, Orthotics and Prosthetics promulgated on July 15, 2024.
A new prior authorization is required for beneficiaries returning to NC Medicaid Direct
An updated version effective Sept. 1, 2022, has been posted to the NC Medicaid Clinical Coverage Policy web page.
Effective Sept. 1, 2022, codes submitted without modifier LT (left), or RT (right) will be denied
An updated version of Clinical Coverage Policy 5B, Orthotics and Prosthetics with an effective date of Feb. 1, 2022, is posted.