Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NC Medicaid Private Duty Nursing Taxonomy Added to the NC Medicaid Home Health 3-A Fee Schedule - Updated
This bulletin replaces the previous bulletin published Nov. 21, 2022.
NC Medicaid Managed Care Quality Strategy Updated
Please provide feedback by Jan. 6, 2023
Advanced Medical Home Provider Manual 2.4.3 Released
Replaces the prior version issued in February 2022
NC Medicaid Begins Tailored Care Management Dec. 1, 2022
A multidisciplinary care team will provide whole-person care management that addresses all of a beneficiary’s needs
NC Medicaid Managed Care Provider Update – Nov. 29, 2022
Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more
Vaccine Immunization Claims Can Be Submitted on Pharmacy Claims for NC Medicaid Direct Beneficiaries
Effective Dec. 1, 2022, pharmacy providers who administer immunizations at pharmacies may bill NC Medicaid Direct for vaccines on pharmacy claims
Sterilization Procedures for Hospital Providers
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.
Ranibizumab-eqrn Injection, for Intravitreal Use (Cimerli™) HCPCS Code J3590: Billing Guidelines
Effective with date of service Oct. 3, 2022, Medicaid and NC Health Choice cover Ranibizumab-eqrn injection, (Cimerli)
Indigotindisulfonate Sodium Injection, for Intravenous Use (Bludigo™) HCPCS Code: Billing Guidelines
Effective with date of service Sept 30, 2022, Medicaid and NC Health Choice cover Indigotindisulfonate sodium injection (Bludigo)
Duplicate Billing of Long-Acting Reversible Contraceptive Claims, From Point-of-Sale Pharmacy Claims and Duplicated on Professional Claims
This error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.