Medicaid Bulletin
Spending Plan for the Implementation of NC Medicaid’s Home & Community Based Services Improvements in Response to COVID-19
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
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
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
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
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
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)
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
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
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
Revisions have been made to Clinical Policy 1A-20, Sleep Studies and Polysomnography Services effective May 1, 2021.
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
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