Medicaid Bulletin

CMS and the American Medical Association have released a CPT code for an antigen test designed to detect proteins from the virus that causes COVID-19 in respiratory specimens. NC Medicaid is adding this CPT code to NCTracks for medically necessary laboratory testing effective Sept. 1, 2020.

Guidelines for Evidenced-Based Synagis® Prophylaxis, Prior Approval Requests, Dose Authorization, Pharmacy Distributor Information, Provider Information, Submitting a Request to Exceed Policy and Technical Support.

Effective Sept. 1, 2020, the North Carolina Medicaid and NC Health Choice Programs will cover Oncotype Dx and EndoPredict genomic tests used for breast cancer treatment as part of Clinical Coverage policy 1S-7, Gene Expression Profiling for Breast Cancer.

NC Medicaid is temporarily increasing financial assistance to Federally Quality Health Centers (FQHCs) and Rural Health Centers (RHCs) to maintain critical access to care for Medicaid beneficiaries during the COVID-19 public health emergency. 

Medicaid/CHIP providers who have not yet submitted their applications for federal Provider Relief Fund are encouraged to apply. The deadline is Sunday, Sept. 13, 2020.

This bulletin outlines the process by which nursing homes may access interim payments of State-administered federal funding to support compliance with Secretarial Order No.2.

NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA)
 

NC Medicaid is reimbursing COVID-19 testing costs for individuals without insurance who enroll in the NC Medicaid Optional COVID-19 Testing (MCV) program. 

Providers are required by State Health Director Order to report all results, positive and negative, of diagnostic testing for SARS-CoV-2, the virus that causes COVID-19.

NC Immunization Program/Vaccines for Children (NCIP/VFC), Billing/Reporting Influenza Vaccines for Medicaid Beneficiaries, Borrowing and Replacement of VFC and Private Vaccines, Borrowing and Replacement of VFC and Private Vaccines, Billing/Reporting Influenza Vaccines for NC Health Choice Beneficiaries, Immunization Billing for Medicaid and NC Health Choice Beneficiaries from FQHCs and RHCs and NDC’s Change Each Year for Influenza Vaccines.