NC Medicaid is in the process of revising the public fee schedule postings platform. One of the initial steps in our revision process requires that NC Medicaid review all fee schedules to ensure the most current and accurate rates are reflected on our fee schedules and in NCTracks to provide the appropriate reimbursement to providers.
NC Medicaid Pharmacy Clinical Policy and Provider Reimbursement sections have reviewed the NC Medicaid Fee Schedule for Physician Administered Drug Program (PADP). As a result of the review, it has been determined that the PADP Medicaid fee schedule, as posted on the NC Medicaid website, requires multiple rate updates to align with First Data Bank, the State Maximum Allowable Cost (SMAC) tables and current rates in NCTracks.
Additional communication will be released to Physician providers to advise of any claims reprocessing that may be required. NC Medicaid will initiate claims reprocessing to pay affected claims accordingly.
Providers are advised to review the revised Physician-Administered-Drug-Program-Fee-Schedule.
Contact
NCTracks Call Center: 800-688-6696