Medicaid Bulletin

Medicaid corrected the reimbursement issue and reprocessed claims for nerve conduction tests performed by physical therapists.

This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.

Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.

The PDM/CVO solution will consolidate provider data management and coordinate provider enrollment, credentialing, and ongoing data maintenance.

Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation

Includes medical and pharmacy prior authorizations, out of network provider rates and rules, and primary care provider changes

Usage of the Nicotine Replacement Therapy Protocol is Eligible for Clinical Services Reimbursement to Pharmacies.

Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.

Feedback Requested on Proposed Approach

To support the SNF and ICF-IID reporting and collection of provider healthcare assessment data.