Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Electronic Visit Verification for Home Health Services: Revised Implementation Dates - March 31, 2023
Implementation guidelines reflect the Tailored Plan launch date of Oct. 1, 2023.
Update to Billable Codes Used for Social Drivers of Health
Effective April 1, 2023, NC Medicaid is updating its guidance around billable codes for social drivers of health.
Medication-Assisted Treatment for Opioid Use Disorders in Skilled Nursing Facilities
Guidance for medication-assisted treatment in skilled nursing facilities
Identifying Other Found Insurance for NC Medicaid Managed Care Members
Process change for Providers identifying Other Found Insurance for NC Medicaid Managed Care Members
Durable Medical Equipment and Orthotic and Prosthetic Manually Priced Procedure Codes - Prior Authorization Update
A new prior authorization is required for beneficiaries returning to NC Medicaid Direct
piflufolastat F18 Injection, for Intravenous Use (Pylarify®) HCPCS Code A9595 - Piflufolastat f-18, diagnostic, 1 millicurie: Billing Guidelines
Effective with date of service, Dec. 21, 2022, the NC Medicaid and NC Health Choice programs cover piflufolastat F18 injection
2023 NC Medicaid Quality Symposium - Partnering for Performance
Register now for the diabetes self-management presentation on May 11 and adolescent immunization on May 16.
Local Management Entity/Managed Care Organization Enrollment Changes for April 1, 2023
Behavioral health prior authorizations effective April 1, 2023
NC Medicaid Managed Care Provider Update – March 22, 2023
Implementation of Tailored Plans, playbook update, Provider reverification, NC Health Choice move to Medicaid, NCTracks Provider records and more.
Lantus Update on NC Medicaid Preferred Drug List for NC Medicaid Direct
Lantus® SoloStar® / Vial will move to preferred on the NC Medicaid Preferred Drug List, effective March 24, 2023.