Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NCDHHS Delays Implementation of the NC Medicaid Managed Care Behavioral Health and I/DD Tailored Plans

Implementation is delayed until Oct. 1, 2023.

Provider Reverification Process to be Reinstated at End of Federal Health Emergency

Federal law requires all Medicaid providers to complete the recredentialing process.

Policy Update for Behavioral Health Providers Effective Feb. 15, 2023

Clinical Coverage Policy 8A, Mobile Crisis Management and State Plan Update

NC Medicaid’s Community Health Worker Strategy Guidance Paper

Support local capacity to overcome persistent health inequities by empowering and deploying community health workers (CHWs) and other care extenders to improve population health and support equitable health outcomes.

Updated Sterilization Consent Form

This bulletin replaces Updated Sterilization Consent Form published on Feb. 14, 2023.

Updated Sterilization Consent Form

The sterilization consent form found on the U.S. Department of Health & Human Services website has been updated.

tremelimumab-actl Injection, for Intravenous Use (Imjudo®) HCPCS Code J9999 - Not Otherwise Classified, Antineoplastic Drugs: Billing Guidelines

Effective Nov. 16, 2022, Medicaid and NC Health Choice cover tremelimumab-actl injection.

Teplizumab-mzwv Injection, for Intravenous Use (Tzield™) HCPCS Code J3590 - Unclassified Biologics: Billing Guidelines

Effective Dec. 1, 2022, Medicaid and NC Health Choice cover teplizumab-mzwv injection.

mirvetuximab soravtansine-gynx Injection, for Intravenous Use (Elahere™) HCPCS Code J9999 - Not Otherwise Classified, Antineoplastic Drugs: Billing Guidelines

Effective Dec. 15, 2022, Medicaid and NC Health Choice cover mirvetuximab soravtansine-gynx injection.

Federal Enrollment Application Fee Increase for Year 2023

The federal fee for Medicaid enrollment has increased to $688 for calendar year 2023.