Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NC Medicaid Managed Care Provider Update – April 21, 2023
Provider reverification, Tailored Plans start date Oct. 1, upcoming key milestones, playbook updates, billing requirement modifications and more.
NC Medicaid CAP/C Waiver Renewed through 2028
The waiver has received approval for another five years through Feb. 29, 2028.
REMINDER: Updates to Skilled Nursing Facility Provider Assessment Rates
Quarterly assessment rate adjustments begin April 1, 2023
Electronic Visit Verification for Home Health Services: Revised Implementation Dates - March 31, 2023
Implementation guidelines reflect the Tailored Plan launch date of Oct. 1, 2023.
Update to Billable Codes Used for Social Drivers of Health
Effective April 1, 2023, NC Medicaid is updating its guidance around billable codes for social drivers of health.
Medication-Assisted Treatment for Opioid Use Disorders in Skilled Nursing Facilities
Guidance for medication-assisted treatment in skilled nursing facilities
Identifying Other Found Insurance for NC Medicaid Managed Care Members
Process change for Providers identifying Other Found Insurance for NC Medicaid Managed Care Members
Durable Medical Equipment and Orthotic and Prosthetic Manually Priced Procedure Codes - Prior Authorization Update
A new prior authorization is required for beneficiaries returning to NC Medicaid Direct
piflufolastat F18 Injection, for Intravenous Use (Pylarify®) HCPCS Code A9595 - Piflufolastat f-18, diagnostic, 1 millicurie: Billing Guidelines
Effective with date of service, Dec. 21, 2022, the NC Medicaid and NC Health Choice programs cover piflufolastat F18 injection
2023 NC Medicaid Quality Symposium - Partnering for Performance
Register now for the diabetes self-management presentation on May 11 and adolescent immunization on May 16.