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Clinical Coverage Policies

Friday, February 1, 2019

The following new or amended clinical coverage policies are available on NC Medicaid’s website at

• 1A-26, Deep Brain Stimulation – 02-01-2019
• 1A-33, Vagus Nerve Stimulation for the Treatment of Seizures – 02-01-2019
• 1K-1, Breast Imaging Procedures – 02-01-2019
• 1K-7, Prior Approval for Imaging Services – 02-01-2019 – 02-01-2019
• 8J, Children's Developmental Service Agencies (CDSAs) – 02-01-2019
• 9B, Hemophilia Specialty Pharmacy Program – 02-01-2019

These policies supersede previously published policies and procedures. Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.

NC Medicaid Clinical Policy, (919) 855-4260