Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
The Advanced Medical Home Tier Attestation Tool, available on the NCTracks Secure Provider Portal Status and Management page has been modified. Providers may use this tool to downgrade from an AMH Tier 3 level provider to an AMH Tier 2 level provider.
The portal for providers to request reimbursement for COVID-19 related primary care services for uninsured individuals is live and can be accessed through the NCTracks secure portal.
Effective with the date of service Oct. 1, 2020, CMS has added new HCPCS codes (J codes), deleted others and changed the description of some existing codes.
Attention Advanced Medical Homes, Carolina Access and CCNC Primary Care Practices
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.
Consistent with the federal Department of Health and Human Services’ extension of the federal COVID-19 Public Health Emergency to January 21, 2021, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies to that same date.
All temporary Durable Medical Equipment (DME) policy flexibilities outlined in COVID-19 Special Bulletins remain in effect. An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of Oct. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy web page.
All temporary Durable Medical Equipment (DME) policy flexibilities outlined in COVID-19 Special Bulletins remain in effect. An amended version of Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies with an effective date of Oct. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy web page.
Effective with date of service Aug. 20, 2020, the Medicaid and NC Health Choice programs cover viltolarsen injection, for intravenous use (Viltepso™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service Aug. 24, 2020, the NC Medicaid and NC Health Choice programs cover satralizumab-mwge injection, for subcutaneous use (Enspryng™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.