Medicaid Bulletin

Effective Oct. 22, 2021, NC Medicaid-enrolled providers can bill code 99401 with HM modifier for telephone outreach to unvaccinated Medicaid beneficiaries.

Effective with date of service Aug. 27, 2021, NC Medicaid covers selexipag for injection.

Medicaid has become aware that some providers have rendered this service without obtaining prior approval.

Clinical Coverage Policy 1E-6, Transitioned to Pregnancy Management Program Effective July 1, 2021.

Effective with date of service Aug. 10, 2021, NC Medicaid covers avalglucosidase alfa-ngpt for injection.

Cost sharing, such as deductibles, coinsurance, or copayments are waived for any Medicaid service.

Individual Provider Affiliation required for certain providers by Nov. 21, 2021. Keeping NCTracks records current can help claims processing.

In response to the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective Aug. 1, 2020.

PA waiver extended to October 31, 2021

The portal has been updated with an enhanced view of Financial and Testing submissions for participating providers.