Medicaid Bulletin

Updates to Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies

Tuesday, October 20, 2020

All temporary Durable Medical Equipment (DME) policy flexibilities outlined in COVID-19 Special Bulletins remain in effect. An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of Oct. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy web page. 

Updates to Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies

Tuesday, October 20, 2020

All temporary Durable Medical Equipment (DME) policy flexibilities outlined in COVID-19 Special Bulletins remain in effect. An amended version of Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies with an effective date of Oct. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy web page.
 

Continuous Glucose Monitoring Systems Coverage Transition

Tuesday, July 21, 2020

Effective July 1, 2020, coverage of therapeutic Continuous Glucose Monitoring (CGM) products is transitioning from the Durable Medical Equipment (DME) Program to the Outpatient Pharmacy Point of Sale (POS) Program. 

SPECIAL BULLETIN COVID-19 #52: Coverage for Weight Scales and Portable Pulse Oximeters - Temporary Flexibilities

Monday, April 20, 2020

Effective retroactive to March 10, 2020, Medicaid and NC Health Choice plans are temporarily covering weight scales and adding a purchase option for portable pulse oximeters.

HCPCS CODE A4252: Blood Ketone Test or Reagent Strip

Tuesday, October 15, 2019

Per Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies on the NC Medicaid website, HCPCS code A4252 (blood ketone test or reagent strip, each) has a quantity limitation of 100 test strips per month. Considering the national description of A4252 refers to each test strip, DME providers are reminded to submit their claims with the number of test strips supplied to the beneficiary, not the number of boxes of test strips.

Updates to Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies

Tuesday, October 1, 2019

On Oct. 1, 2019, an amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies, was posted to the North Carolina Medicaid website. In addition to correcting numbering, grammatical and style errors, several changes have been made.

Special Bulletin: Review of Durable Medical Equipment Rates

Friday, December 21, 2018

NC Medicaid has been reviewing the Medicaid Durable Medical Equipment rates to comply with the new Centers for Medicare and Medicaid Upper Payment Limit requirements. While further review is needed, NC Medicaid wanted to publish this bulletin to provide a status update.

Upcoming DME Changes to the Roche Rebate Program for Preferred Roche Diabetic Supplies

Monday, March 5, 2018

Beginning April 1, 2018, diabetic testing supplies will be transitioned to the North Carolina Medicaid and NC Health Choice Preferred Drug List (PDL) and Roche diabetic testing supplies will remain preferred.

Updates to Clinical Coverage Policy 5A-2: Non-invasive Ventilator Policy

Thursday, February 8, 2018

Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies, is updated to add policy guidelines for home ventilators with a non-invasive interface and to add HCPCS codes E0466 to the Durable Medical Equipment and Supplies fee schedule as a continuous rental.

Subscribe to Medicaid Bulletins Updates

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Associated Files