Topics Related to Pharmacy Providers

NC Medicaid to Add Coverage for Obesity Management Medications

Effective Aug. 1, 2024, NC Medicaid will cover obesity management medications for beneficiaries 12 years of age and older.

Opill to be Covered Without a Prescription

Effective Aug. 1, 2024, over the counter oral contraceptive Opill will be available without a prescription, at no cost.

Nicotine Replacement Therapy Protocol Reimbursement Effective Aug. 1, 2024

Usage of the Nicotine Replacement Therapy Protocol is Eligible for Clinical Services Reimbursement to Pharmacies.

Transition to Quarterly Meetings for the Preferred Drug List Review Panel

The next review panel meeting is April 11, 2024

NC Medicaid to Cover Imported Benzathine Benzylpenicillin (Extencilline): Billing Guidelines

Effective with date of service Jan. 16, 2024, NC Medicaid covers benzathine benzylpenicillin (Extencilline)

Over-the-Counter COVID-19 Test for Home Use Pharmacy POS Coverage

CorDx, GoToKnow, FaStep COVID-19 AG Home Tests added to coverage.

Additional NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024

This bulletin replaces the NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024 - Revised published Nov. 3, 2023.

Immunizing Pharmacists Enrollment Opening in January 2024

North Carolina Medicaid will reimburse pharmacies for utilizing the statewide Self-Administered Hormonal Contraceptive Protocol for pharmacists.

Requirements for Filling Prescriptions for Medicaid Beneficiaries: Reminder for the Expansion Population

NC Medicaid requires prescriptions to be ordered by Medicaid enrolled providers.

Reprocessing of Outpatient Claims with Revenue Code 025x and 063x and Missing Required Data

Starting in November 2023, Standard Plans and Medicaid Direct will reprocess claims without appropriate documentation of required codes.