Topics Related to Physicians, Physician Assistants and Nurse Practitioners

Effective with date of service Oct. 2, 2020, the Medicaid and NC Health Choice programs cover ferric derisomaltose injection, for intravenous use (Monoferric™) for use in the Physician Administered Drug Program.

This information is only for non-long-term care providers who have the means to handle the specific storage recommendations required of the Moderna COVID-19 vaccine and will be administering it. 

Effective with date of service Nov. 13, 2020, the Medicaid and NC Health Choice programs cover meningococcal [Groups A, C, Y, W] conjugate vaccine, solution for intramuscular injection (MenQuadfi™) for use in the Physician Administered Drug Program. 

Effective with date of service Jan. 1, 2020, the Medicaid and NC Health Choice programs cover famotidine injection (Pepcid®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective with date of service Aug. 24, 2020, the NC Medicaid and NC Health Choice programs cover satralizumab-mwge injection, for subcutaneous use (Enspryng™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.

Effective with date of service Aug. 6, 2020, the Medicaid and NC Health Choice programs cover belantamab mafodotin-blmf for injection, for intravenous use (Blenrep™) 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 Sept. 11, 2020, the Medicaid and NC Health Choice programs cover infliximab-axxq for injection, for intravenous use (Avsola) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code Q5121 - Injection, infliximab-axxq, biosimilar, (avsola), 10 mg.

Effective with date of service Aug. 20, 2020, the Medicaid and NC Health Choice programs cover viltolarsen injection, for intravenous use (Viltepso™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective with date of service Aug. 13, 2020, the Medicaid and NC Health Choice programs cover tafasitamab-cxix for injection, for intravenous use (Monjuvi®) 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 July 27, 2020, the Medicaid and NC Health Choice programs cover inebilizumab-cdon injection, for intravenous use (Uplizna™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.