Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Changes have been made to the Clinical Pharmacy Practitioners (CPPs) fee schedule to more accurately reflect the types of services provided by a CPP certified by the NC Board of Pharmacy.

The Department is releasing the draft Tailored Care Management Desk Review Guide and Scoring Tool to support providers applying for AMH+ or Care Management Agency certification. 

To ensure NC Medicaid continues to move forward with EVV implementation and can fully integrate EVV through claims adjudication for all providers, alternate EVV solutions must pass testing validation by April 30, 2021.

This bulletin provides an update on the final reconciliation activity related to nursing facility staff COVID-19 testing payments authorized under Secretarial Orders No. 2 and No. 4.

Providing the most accurate and complete provider information is a top priority so Medicaid and NC Health Choice beneficiaries can make the most informed choice for their health plan and primary care provider. 

NC Medicaid is making system modifications that will start the process of 45 and 60 day notifications of suspension if a provider fails to update their credential prior to the expiration date. 

Effective with the date of service April 1, 2021, the Centers for Medicare & Medicaid Services added new HCPCS codes (J codes), deleted others and changed the description of some existing codes. 

Effective July 1, 2021, NC Medicaid will increase fee-for-service rates and establish rate floors for facility-based crisis and mobile crisis management services that will mandate minimum reimbursement rates.

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

Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.