Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

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)
Updated Coverage for Psychiatric Collaborative Care Management Effective Dec. 1, 2022
Includes HCPCS Code G0512 for RHCs and FQHCs
NC Medicaid Private Duty Nursing Taxonomy Added to the NC Medicaid Home Health 3-A Fee Schedule
Taxonomy numbers are not included in Clinical Policy but are included in the associated Fee Schedules.
Feedback Requested: NC Medicaid Care Delivery and Value-Based Payment Design
We encourage stakeholders to provide feedback by Dec. 19, 2022.
Enhanced Medical Home Payments for Advanced Medical Homes Serving Members Eligible for Tailored Care Management
The $20 PMPM Medical Home Payments for AMHs serving members eligible for Tailored Care Management will begin in December.
Tailored Care Management Implements Temporary Flexibilities and Program Changes
Temporary flexibilities and changes run from Dec. 1, 2022, to March 31, 2023.
Update: North Carolina Standard Plan and Tailored Plan Tobacco-Free Policy Requirements
NCDHHS will delay the implementation of North Carolina Standard Plan and Tailored Plan Tobacco-Free Policy requirements.
Notice to Class of Proposed Settlement of Franklin v. Kinsley
Please post in a prominent location such as patient waiting rooms as soon as possible.
Pfizer-BioNTech COVID-19 Vaccine, Bivalent 5 years through 11 years HCPCS Code 91315: Billing Guidelines
Effective with date of service August 31, 2022, Medicaid and NC Health Choice cover Pfizer-BioNTech COVID-19 Vaccine
New Fee Schedule and Covered Codes Webpage Live
All fee schedules currently listed on the NC Medicaid website have been moved to a new Fee Schedule and Covered Code Portal available to the public.