Medicaid Bulletin

Coverage for single booster dose

Effective Sept. 1, 2022, codes submitted without modifier LT (left), or RT (right) will be denied

NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.

A new PA is required for beneficiaries returning to NC Medicaid Direct.

EPSDT Prior Authorization Available July 1, 2022

New billable codes available Sept.1 to address social drivers of health

Prior to submitting an application for Advanced Medical Home/Care Management Agency Certification, please download and utilize the Provider Directory Listing Report.

An updated version of the policy with an amendment date of May 15, 2022, is posted.

Beginning Jan. 1, 2023, substantive portion means more than half of the total time spent by the physician and NPP performing the shared/split visit

Three claims processing edits to end with Public Health Emergency