Medicaid Bulletin

Providers will continue to follow Personal Care Services in In-home settings (3L) from Jan. 1, 2025, through March 31, 2025.

Effective Feb. 1, 2025, updated unit limitations will be applied to some allergy testing and immunotherapy CPT codes.

The implementation of the Rate Reimbursement Methodology for individuals living in congregate settings will take effect on April 1, 2025.

Children with NC Medicaid temporarily living in another state can get a free Vaccine for Children (VFC) vaccine from any VFC provider in that state.

Effective Jan. 1, 2025, NC Medicaid will cover U.S. Food & Drug Administration approved cell and gene therapies

Effective with date of service Jan. 1, 2025, new CPT codes have been added, some end-dated, and descriptions of some existing codes have been updated

This bulletin has updated end dates & additional flexibilities for Behavioral Health, Care Management, Innovations, and Long-Term Services & Supports.

This is an update to the September 2016 Medicaid Ordering, Prescribing or Referring Special Bulletin.

Comments accepted through Jan. 6, 2024.