Medicaid Bulletin

The public version of the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool is now available. Providers are encouraged to use this tool to confirm the availability and accuracy of information contained in their NCTracks provider enrollment record.

The information in this bulletin is only for pharmacies administering vaccines outside of the CVS/Walgreens Long-Term Care program who have the means to handle the specific storage recommendations required of the COVID-19 vaccine and will be administering it. 

In response to the Federal Department of Health and Human Services’ extension of the Federal COVID-19 Public Health Emergency, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through March 31, 2021. 

After Jan. 31, 2021, providers are required to capture EVV visits for all beneficiaries subject to EVV. Claims paid for services that are not captured through EVV may be subject to recoupment. 

NC Medicaid has approved codes for COVID-19-related medically necessary laboratory testing and has completed adding these services in NCTracks. Please note there are other codes currently under review that will be posted at a later date.

NC Medicaid Clinical Coverage Policy 3L, State Plan Personal Care Services, is being amended to reflect the 21st Century Cures Act federal requirement of implementing Electronic Visit Verification for Personal Care Services.

New or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.

Select provider types enrolled in the NC Medicaid Program are required to file annual Medicaid cost reports utilizing cost reporting schedules which are based on approved Medicare cost reporting platforms.

To support continued access to dental care for Medicaid and NC Health Choice beneficiaries in North Carolina at a time when providers are facing challenges posed by the COVID-19 public health emergency, NC Medicaid will be making financial assistance payments to dental providers who serve meaningful numbers of Medicaid and NC Health Choice beneficiaries.

The Provider Directory Listing Report and Provider Affiliation Report is now available to providers as they prepare for Medicaid Managed Care.