Medicaid Bulletin

The seven-part series covers current policies and procedures under the new NC Medicaid Managed Care guidelines.

Standard Plans temporarily extended minimum appeal timeframes to support the transition to NC Medicaid Managed Care.

The Food and Drug Administration and the Advisory Committee on Immunization Practices have authorized COVID-19 boosters for all adults (18 years and older).

The Pre-Admission Screening and Resident Review application has changed its website domain address.

The December 2021 NC Medicaid Personal Care Services Public Health Emergency Uniform rates previously released in Special Bulletin COVID-19 #194 are being revised effective Dec. 1, 2021.

NC Medicaid has extended its deadline to February 2022 to send the renewed waiver application to the Centers for Medicare and Medicaid Services to request approval of the CAP/C waiver for another five years.

Effective with date of service Sept. 22, 2021, the Medicaid and NC Health Choice programs cover tisotumab vedotin-tftv for use in the PADP when billed with HCPCS code J9999.

NC Medicaid is extending all current COVID-19 temporary provider rate increases through Dec. 31, 2021.

Effective with date of service Aug. 23, 2021, the Medicaid and NC Health Choice programs cover pneumococcal 20-valent conjugate vaccine for use in the PADP when billed with HCPCS code 90677.

Billing guidelines for PADP when billed with HCPCS code J3490.