Verification of School Nursing Form and Instructions Added

Monday, February 5, 2018

The Verification of School Nursing Form – Attachment I (DMA-3171), and Instruction Sheet (DMA-3171-I) are now on the NC Medicaid PDN forms web page. The form is used to document Private Duty Nursing (PDN) school hours in accordance with Section 3.4.1, PDN and Schools, of Clinical Coverage Policy 3G-2, Private Duty Nursing for Beneficiaries Under 21 Years of Age.

Author: 
Home Care Services/Community Based Services, DMA, 919-855-43