Medicaid Bulletin

Articles published prior to January 2018 are available in the Medicaid Bulletin Archive.

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

An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of March 1, 2025, was posted to the NC Medicaid Clinical Coverage Policy web page.

Updated Reimbursement Guidance for Psychiatric Collaborative Care Management
NC Medicaid added coverage for Healthcare Common Procedure Coding System (HCPCS) Code G0512 for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Upcoming Multi-Factor Authentication Changes for Pre-Admission Screening and Resident Review Users
Starting April 15, 2025, Pre-Admission Screening and Resident Review (PASRR) users must use Multi-Factor Authentication (MFA) via MyNCID to enhance security.
New Laboratory Codes for Celiac Disease Diagnosis and Management
Effective Date: April 1, 2025.
Point-of-Sale COVID and Flu Vaccine Reimbursement Updates 2025
The PREP Act is extended to Dec. 31, 2029, expanding COVID-19 and flu vaccine access at pharmacy Point-of-Sale for ages 3 and older.
Revisions to Inclusion of Drug Code Rates on Fee Schedules
Effective Feb. 3, 2025, unless communicated otherwise by the Department
NC Medicaid Managed Care Provider Update February 17, 2025
Information on Hurricane Helene Flexibilities, OPR Updates, MFA for All NCTracks Users, and more.
UPDATED: Retainer Payments for Home and Community-Based Service Providers Impacted by Hurricane Helene
Providers affected by Hurricane Helene have additional time to submit requests for services
Procedural Policy Guidance for Early Periodic Screening, Diagnosis and Treatment (EPSDT) and Health Check Program Guide Updates
Includes Consolidated Appropriations Act Section 5121 Guidance.
Health Plan Interest for Provider Claims
Health plans are required to pay interest to providers if they fail to accurately pay or inappropriately deny a claim.