NC Medicaid Managed Care Quality Strategy Updated

Please provide feedback by Jan. 6, 2023

Advanced Medical Home Provider Manual 2.4.3 Released

Replaces the prior version issued in February 2022

NC Medicaid Begins Tailored Care Management Dec. 1, 2022

A multidisciplinary care team will provide whole-person care management that addresses all of a beneficiary’s needs

NC Medicaid Managed Care Provider Update – Nov. 29, 2022

Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more

Vaccine Immunization Claims Can Be Submitted on Pharmacy Claims for NC Medicaid Direct Beneficiaries

Effective Dec. 1, 2022, pharmacy providers who administer immunizations at pharmacies may bill NC Medicaid Direct for vaccines on pharmacy claims

Sterilization Procedures for Hospital Providers

This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.

Ranibizumab-eqrn Injection, for Intravitreal Use (Cimerli™) HCPCS Code J3590: Billing Guidelines

Effective with date of service Oct. 3, 2022, Medicaid and NC Health Choice cover Ranibizumab-eqrn injection, (Cimerli)

Indigotindisulfonate Sodium Injection, for Intravenous Use (Bludigo™) HCPCS Code: Billing Guidelines

Effective with date of service Sept 30, 2022, Medicaid and NC Health Choice cover Indigotindisulfonate sodium injection (Bludigo)

Duplicate Billing of Long-Acting Reversible Contraceptive Claims, From Point-of-Sale Pharmacy Claims and Duplicated on Professional Claims

This error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.

Bevacizumab-maly Injection, for Intravenous Use (Alymsys®) HCPCS Code J9999: Billing Guidelines

Effective with date of service Oct. 5, 2022, Medicaid and NC Health Choice cover Bevacizumab-maly injection (Alymsys)

https://medicaid.ncdhhs.gov/providers/medicaid-bulletin