Effective with date of service July 1, 2021, the Medicaid and NC Health Choice cover bupivacaine and meloxicam extended-release solution.
Topics Related to Physicians, Physician Assistants and Nurse Practitioners
Effective with date of service June 28, 2021, the Medicaid and NC Health Choice programs cover dasiglucagon injection, for subcutaneous use (Zegalogue®)
Effective with date of service July 15, 2021, Medicaid and NC Health Choice cover asparaginase erwinia chrysanthemi (recombinant)-rywn injection, for intramuscular use (Rylaze™)
Effective with date of service July 8, 2021, the Medicaid and NC Health Choice programs cover oritavancin for injection, for intravenous use.
The FDA has modified the Emergency Use Authorizations (EUAs) for Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine to allow for administration of a third dose of an mRNA COVID-19 vaccine after an initial two-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people.
Effective with date of service May 11, 2021, the Medicaid and NC Health Choice programs cover loncastuximab tesirine-lpyl for injection, for intravenous use (Zynlonta) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective with date of service June 9, 2021, the Medicaid and NC Health Choice programs cover amivantamab-vmjw injection, for intravenous use (Rybrevant) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 – Not otherwise classified antineoplastic drugs.
Effective with date of service May 17, 2021, the Medicaid and NC Health Choice programs cover dostarlimab-gxly injection, for intravenous use (Jemperli) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Update on coverage of medications used in the Physician Administered Drug Program when billed with HCPCS code 90697.
Updates to Clinical Coverage Policy 10B, Outpatient Specialized Therapies, Independent Practitioners
On July 1, 2021, an amended version of the policy was posted.