Medicaid Bulletin

NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA).

The North Carolina Department of Health and Human Services and the NC Area Health Education Center are partnering in a free webinar series, DHHS COVID-19 Guidance for Dental Professionals, designed to support dental providers during the COVID-19 pandemic. 

North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners and physician assistants.

This bulletin replaces SPECIAL BULLETIN COVID-19 #79 in its entirety. NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid beneficiaries. 
 

The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association have announced the release of several new codes to report testing for active cases of Coronavirus (COVID-19) as well as detection of antibodies.   

CARES Act Provider Relief Fund Webcast, Information for Medicaid Providers and a Checklist for Medicaid Providers Eligible for Federal Relief.

Effective with date of service April 23, 2020, the Medicaid and NC Health Choice programs cover sacituzumab govitecan-hziy for injection, for intravenous use (Trodelvy™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service April 7, 2020, the Medicaid and NC Health Choice programs cover meloxicam injection, for intravenous use (Anjeso™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective with date of service Dec. 28, 2019, the Medicaid and NC Health Choice programs cover emapalumab-lzsg injection, for intravenous use (Gamifant™) for use in the Physician Administered Drug Program (PADP) outpatient hospital setting (only) when billed with HCPCS code J9210 - Injection, emapalumab-lzsg, 1 mg.

Per Section 4.6 of the North Carolina General Assembly’s recently approved Session Law 2020-4 (House Bill 1043), NC Medicaid is implementing a 5% rate increase for all Fee-For-Service (FFS) Medicaid providers who had not yet received a 5% increase during the COVID-19 public health emergency.