SPECIAL BULLETIN COVID-19 #29: Coverage for Automatic Blood Pressure Monitors: Temporary Flexibilities Effective March 30, 2020

<p>Updated April 22, 2020: Link to downloadable list of enrollmed DMEPOS providers added. Effective March 30, 2020 NC Medicaid and NC HealthChoice coverage was added for HCPCS code A4670 &ndash; automatic blood pressure monitor.</p>

Author: GDIT, (800) 688-6696

Update April 22, 2020: To assist prescribers in the identification of suppliers in their area, a link to a downloadable list of enrolled DMEPOS providers was added.

Effective March 30, 2020, North Carolina Medicaid and NC HealthChoice coverage was added for HCPCS code A4670automatic blood pressure monitor. If medically necessary, this item may be provided without prior authorization to beneficiaries who are required to independently monitor their blood pressure from home. Coverage for this item is available through the following clinical programs:

  • Durable Medical Equipment and Supplies (clinical coverage policy 5A-3)
  • Home Health Services (clinical coverage policy 3A)
  • Home Infusion Therapy (clinical coverage policy 3H-1)
  • Private Duty Nursing (clinical coverage policies 3G-1 and 3G-2)

Suppliers must maintain the usual documentation of medical necessity and records per applicable policy guidance. All claims are subject to audit.

A downloadable list of enrolled DMEPOS providers with location and contact information is available.

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