Medicaid Bulletin

Spending Plan for the Implementation of NC Medicaid’s Home & Community Based Services Improvements in Response to COVID-19

Friday, June 11, 2021

NC Medicaid is seeking input from people who work in HCBS, those who receive care and the public on how North Carolina can most effectively allocate the funds. 

Electronic Visit Verification Implementation Update: Beginning of EVV Claim Adjudication, Alt EVV and Other Topics

Wednesday, June 9, 2021

This Bulletin contains updates on the implementation of electronic visit verification (EVV) claims adjudication, entering manual visits, alternate EVV solutions, EVV system updates, EVV implementation for Innovations and TBI Waivers administered by LME-MCOs, EVV implementation for managed care health plans, and quick help tips and resources. 

Melphalan Flufenamide for Injection (Pepaxto®) HCPCS Code J9999: Billing Guidelines

Tuesday, June 8, 2021

Effective April 5, 2021, Medicaid and NC Health Choice cover melphalan flufenamide for injection, for intravenous use. 

Billing Code Update for Nurse Practitioners and Physician Assistants

Tuesday, June 8, 2021

The following procedure code list has been updated recently to include additional nurse practitioner and physician assistant taxonomies.

Attention Providers: Failure to Update Expiring Credentials Results in Pended Claims

Tuesday, June 8, 2021

Beginning May 9, 2021, NC Medicaid initiated additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks provider enrollment record.

Adding Coverage for Non-Powered Negative Pressure Wound Therapy

Tuesday, June 8, 2021

The following codes are being added to NCTracks to report negative pressure wound therapy utilizing disposable, non-durable medical equipment. 

Reminder: Providers Required to Update Expiring Credentials (June 2, 2021)

Wednesday, June 2, 2021

NCTracks continues sending notifications of suspension to providers through the Provider Message Center Inbox for failure to update expiring credentials. 

Prior Approval Requirement for High Tech Imaging Terminating July 1, 2021

Wednesday, June 2, 2021

Effective for dates of service on or after July 1, 2021, prior approval for high tech imaging services will no longer be required for North Carolina Medicaid Direct beneficiaries.

SPECIAL BULLETIN COVID-19 #166: NC Medicaid to Sunset CARES Act Funding Support for Nursing Facility Staff Testing Costs

Tuesday, June 1, 2021

NC Medicaid will sunset its CARES Act funded reimbursement of nursing facility staff COVID-19 testing in June 2021. This bulletin provides an update on processing timelines for previously submitted cases and provides additional guidance for final payments under this initiative.

Clinical Policy 1A-20, Sleep Studies and Polysomnography Services Revised Effective May 1, 2021

Tuesday, June 1, 2021

Revisions have been made to Clinical Policy 1A-20, Sleep Studies and Polysomnography Services effective May 1, 2021.

Subscribe to Medicaid Bulletins Updates

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Associated Files