Medicaid Bulletin

Please post in a prominent location such as patient waiting rooms as soon as possible.

Effective with date of service August 31, 2022, Medicaid and NC Health Choice cover Pfizer-BioNTech COVID-19 Vaccine

All fee schedules currently listed on the NC Medicaid website have been moved to a new Fee Schedule and Covered Code Portal available to the public.

Effective with date of service Aug. 31, 2022, Medicaid and NC Health Choice programs cover Moderna COVID-19 Vaccine

Providers are encouraged to review for an overview of other general language and formatting updates.

Effective Nov. 3, 2022, fee schedules currently listed on the NC Medicaid website will move to a new public fee schedule and covered code website.

Effective Oct. 1, 2022, Pluvicto must be billed with HCPCS code A9607

Updated HCPCS Code, unit of coverage and maximum reimbursement rate

The delay in conducting assessments has slowed the generation of prior approvals for the continuation of PCS.

Key milestones, playbook updates, beneficiary eligibility, reverification, provider records, provider ombudsman, help center and webinars.