Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

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An updated version effective Sept. 1, 2022, has been posted to the NC Medicaid Clinical Coverage Policy web page.

Point-of-sale (POS) billing for FDA-authorized over-the-counter (OTC) COVID-19 tests dispensed for use by NC Medicaid beneficiaries in a home setting remains in effect for NC Medicaid Direct and all five managed care plans.

Effective Jan. 1, 2023, new HCPCS procedure code G0330, Facility Services Dental Rehab, will be added to Clinical Coverage Policy 4A, Dental Services.

Revised EVV for Home Health Services implementation dates for NC Medicaid Direct, Standard Plans and Tailored Plans.

In May 2020, CMS updated the Minimum Data Set (MDS) 3.0 item sets to support calculation of Patient-Driven-Payment-Model (PDPM) case mix groups on OBRA assessments. In October 2020, NC Medicaid began requiring the completion and submission of the 28 MDS item set fields associated with PDPM on all OBRA nursing home comprehensive (NC) and quarterly (NQ) MDS assessment submissions.

Effective with date of service Jan. 1, 2023, the American Medical Association (AMA) has added new CPT codes, deleted others, and changed the descriptions of some existing codes. For complete information regarding all CPT codes and descriptions, refer to the 2023 edition of Current Procedural Terminology, published by the AMA.

Last days for providers to have fully executed contracts with Tailored Plans to be included in the beneficiary choice period and auto-assignment.

Highlighting coverage, rate and resource changes in 2022

Beneficiaries can apply for various benefits, view case details, renew their Medicaid and update their information