Medicaid Bulletin

Effective with date of service Oct. 2, 2020, the Medicaid and NC Health Choice programs cover ferric derisomaltose injection, for intravenous use (Monoferric™) for use in the Physician Administered Drug Program.

Effective with date of service Jan. 1, 2021, the American Medical Association has added new CPT codes, deleted others, and changed the descriptions of some existing codes.  

January marks the go-live date for Electronic Visit Verification (EVV) Phase 1 Implementation. Beginning on January 1, 2021, all providers subject to the Federal EVV mandate should make every effort to capture visits through their chosen EVV solution. 

This bulletin updates and extends NC Medicaid’s reimbursement for allowable COVID-19 testing of nursing facility staff and healthcare personnel. 

This information is only for non-long-term care providers who have the means to handle the specific storage recommendations required of the Moderna COVID-19 vaccine and will be administering it. 

Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, has been revised and will post with an effective date of Jan. 1, 2021 on the NC Medicaid website.

Effective Oct. 1, 2020, NC Medicaid will now cover services for transversus abdominis plane blocks for Medicaid and NC Health Choice beneficiaries 11 years and older.

An amended version of Clinical Coverage Policy 1E-7, Family Planning Services with an effective date of Dec. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy webpage.

Program of All-inclusive Care for the Elderly (PACE) organizations should continue to follow the guidance of local, state and federal officials regarding COVID-19 and thoroughly document reasoning for making decisions which may fall outside of the PACE program model.

This bulletin revises the COVID-Response Site criteria established in SPECIAL BULLETIN COVID-19 #82.