To ensure that NC Medicaid meets implementation timelines and can fully integrate EVV through claims adjudication for all providers, alternate EVV Solutions must pass testing validation by March 10, 2021. If the solution has not passed testing by March 10, 2021, provider agencies currently enrolled with their solution may be required to enroll with the State’s EVV solution, Sandata, to ensure they are compliant with EVV requirements.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
Providers have until April 30, 2021, to submit a complete and accurate attestation for Program Year 2020. After that no changes can be made.
Effective with date of service Jan. 1, 2021, the Centers for Medicare & Medicaid Services has identified new CPT and HCPCS codes as separately reimbursable in the ambulatory surgery setting.
In addition to the NC Medicaid Provider webpage, Medicaid and NC Health Choice providers now have a supplemental resource to research their questions and submit inquiries.
NC Medicaid has released the NC Department of Health and Human Services Transition of Care Policy, which outlines NC Medicaid's vision on the process of assisting a beneficiary through the transition between health plans or between service/payment delivery systems.
The Department released the Advanced Medical Home Provider Manual 2.0 today. This version reflects program expectations as well as recent program modifications and changes that impact provider contracts.
The public comment period has been extended through March 15, 2021, for Personal Care Services Policy 3L, Implementation of Electronic Visit Verification.
CPT Code 87428 (related to COVID-19) was improperly defined in a previous Bulletin and is being correctly defined here.
The Community Alternatives Program for Children (CAP) §1915(c) Home- and Community-Based Services (HCBS) waiver will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.
North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).