Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NC Medicaid Managed Care Provider Update – Nov. 29, 2022
Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more
Vaccine Immunization Claims Can Be Submitted on Pharmacy Claims for NC Medicaid Direct Beneficiaries
Effective Dec. 1, 2022, pharmacy providers who administer immunizations at pharmacies may bill NC Medicaid Direct for vaccines on pharmacy claims
Sterilization Procedures for Hospital Providers
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.
Ranibizumab-eqrn Injection, for Intravitreal Use (Cimerli™) HCPCS Code J3590: Billing Guidelines
Effective with date of service Oct. 3, 2022, Medicaid and NC Health Choice cover Ranibizumab-eqrn injection, (Cimerli)
Indigotindisulfonate Sodium Injection, for Intravenous Use (Bludigo™) HCPCS Code: Billing Guidelines
Effective with date of service Sept 30, 2022, Medicaid and NC Health Choice cover Indigotindisulfonate sodium injection (Bludigo)
Duplicate Billing of Long-Acting Reversible Contraceptive Claims, From Point-of-Sale Pharmacy Claims and Duplicated on Professional Claims
This error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.
Bevacizumab-maly Injection, for Intravenous Use (Alymsys®) HCPCS Code J9999: Billing Guidelines
Effective with date of service Oct. 5, 2022, Medicaid and NC Health Choice cover Bevacizumab-maly injection (Alymsys)
Updated Coverage for Psychiatric Collaborative Care Management Effective Dec. 1, 2022
Includes HCPCS Code G0512 for RHCs and FQHCs
NC Medicaid Private Duty Nursing Taxonomy Added to the NC Medicaid Home Health 3-A Fee Schedule
Taxonomy numbers are not included in Clinical Policy but are included in the associated Fee Schedules.
Feedback Requested: NC Medicaid Care Delivery and Value-Based Payment Design
We encourage stakeholders to provide feedback by Dec. 19, 2022.