Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Effective with the date of service of April 30, 2018, the North Carolina Medicaid and Health Choice programs will be terminating Clinical Policy 1B-3, Intravenous Iron Therapy, within the Physician Drug Program.

This email is an update to yesterday’s email and previous North Carolina Medicaid Bulletins. In response to provider feedback, the use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will be extended from January 31, 2018 to April 30, 2018.

The Freestanding Birth Center fee for CPT Code 59409 has been updated to $1,510.97 effective Jan. 1, 2018.

With each prior approval (PA) entry beginning with the third and subsequent benefit periods, providers must fax a copy of the Approval Status Inquiry Form, or the NCTracks Web Submitted Request for Hospice Prior Approval Confirmation Page, to DMA at 919-715-9025. DMA requests that providers include their name and e-mail address on the above forms.

The provision of family planning services and family planning-related services has been the sole purpose of the “Be Smart” Family Planning Medicaid program since it started in October 2005, and continued with the CMS approval of the State Plan Amendment in 2014.

Appropriate maternal depression screening is necessary to ensure that postpartum depression is addressed and care is administered in a timely manner to improve quality of care and long-term outcomes for both mother and child.

Effective Feb. 1, 2018, N.C. Medicaid will cover balloon sinus ostial dilatation (BOD) surgery. The BOD policy will outline the new coverage for applicable CPT procedure codes. 

Registration is open for several instructor-led training courses for providers that will be held in January 2018.

There are only four months left to submit an attestation for Program Year 2017.

Per Session Law (S.L.) 2015-241, as amended by S.L. 2017-57, North Carolina providers who are reimbursed by the state for providing health care services under N.C. Medicaid and N.C. Health Choice programs must join NC HealthConnex, the state-designated Health Information Exchange.