Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Providers are required by State Health Director Order to report all results, positive and negative, of diagnostic testing for SARS-CoV-2, the virus that causes COVID-19.

NC Immunization Program/Vaccines for Children (NCIP/VFC), Billing/Reporting Influenza Vaccines for Medicaid Beneficiaries, Borrowing and Replacement of VFC and Private Vaccines, Borrowing and Replacement of VFC and Private Vaccines, Billing/Reporting Influenza Vaccines for NC Health Choice Beneficiaries, Immunization Billing for Medicaid and NC Health Choice Beneficiaries from FQHCs and RHCs and NDC’s Change Each Year for Influenza Vaccines.  

The deadline for Medicaid/CHIP providers to submit their financial data to apply for federal provider relief funds has been extended to Sept. 13, 2020. 

NC DHHS and the NC Area Health Education Center (AHEC) are partnering in a free webinar series offering guidance to dental professionals.

Effective with date of service July 1, 2020, the Medicaid and NC Health Choice programs cover pertuzumab, trastuzumab, and hyaluronidase-zzxf injection, for subcutaneous use (Phesgo™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service June 17, 2020, the Medicaid and NC Health Choice programs cover mitomycin for pyelocalyceal solution (Jelmyto™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service June 19, 2020, the Medicaid and NC Health Choice programs cover lurbinectedin for injection, for intravenous use (Zepzelca™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service June 26, 2020, the Medicaid and NC Health Choice programs cover bimatoprost implant, for intracameral administration (Durysta™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

A memo regarding North Carolina’s Design for State-Funded Services Under Behavioral Health and Intellectual/Developmental Disability Tailored Plans white paper has been released.

The North Carolina Department of Health and Human Services Division of Health Benefits (DHB) is continuing to implement previously-announced temporary 5% provider rate increases to select Medicaid providers (see COVID-19 Special Bulletin #99) to maintain access to care for Medicaid beneficiaries.