Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Quality Strategy Available for Public Comment
Comments accepted through Jan. 6, 2024.
Out-of-State Enrolled Pharmacies List Now Posted & Updated Daily on NCTracks

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

Federal Provider Enrollment Application Fee Increase for Year 2025
The federal fee for Medicaid enrollment has increased to $730 for calendar year 2025.
Corrections to CPT Code Update Bulletin Effective Jan. 1, 2024

This bulletin applies to NC Medicaid Direct.

Tailored Care Management Temporary Rate Extension
NC Medicaid will continue the current Tailored Care Management temporary payment rate of $343.97 statewide through June 30, 2025.
NC Medicaid Managed Care Provider Update – November 27, 2024
Includes information on Change of Ownership Requirement, Upcoming Webinars, and more.
Revised Reimbursement Methodology for Individuals Living in Congregate Settings Administered by Personal Care Service Providers
Effective Jan. 1, 2025, the unit of reimbursement will change from a 15-minute increment to a daily per diem.
Policy Guidance for Personal Care Services Beneficiaries in Congregate and In-Home Settings
Two policies will be effective on Jan. 1, 2025, and posted to the NC Medicaid website.
Health Plan Interest for Provider Claims
Health plans are required to pay interest to providers if they fail to accurately pay or inappropriately deny a claim.
COVID-19 Vaccine and Reimbursement Guidelines for 2024-2025 for NC Medicaid
Includes information on vaccine reimbursement, billing, counseling coverage and Immunization Program/Vaccines for Children