SPECIAL BULLETIN COVID-19 #54: Clinical Policy Modifications - Family Planning Services Annual Exam Requirement Waived

Monday, April 20, 2020

Note: Additional Family Planning guidance may be released in the future, which would replace this bulletin.

NC Medicaid has temporarily modified its Family Planning Clinical Coverage Policy, 1E-7 to better enable the delivery of remote care to Medicaid beneficiaries. An Annual Exam visit is not required prior to billing for Family Planning services. Claim editing to ensure that annual exams are completed prior to Family Planning visits, as well as HIV Screening and STI Screening and Treatment, have temporarily been suspended. 

These temporary changes are effective beginning March 10, 2020 and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when the policy modification is rescinded. When the temporary modifications end, all face-to-face service requirements will resume.

Additional Resources

NC Medicaid COVID-19 Resources website 

Contact

Medicaid Contact Center: 888-245-0179