Training for Providers begins Friday, June 28. Additional dates are listed in this bulletin.
Medicaid Bulletin
Articles published prior to January 2018 are available in the Medicaid Bulletin Archive.
Provider Data Management / Credentialing Verification Organization (PDM/CVO) Solution New Launch Date of 2026.
Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.
Medicaid corrected the reimbursement issue and reprocessed claims for nerve conduction tests performed by physical therapists.
This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.
Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.
The PDM/CVO solution will consolidate provider data management and coordinate provider enrollment, credentialing, and ongoing data maintenance.
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation
Includes medical and pharmacy prior authorizations, out of network provider rates and rules, and primary care provider changes
Usage of the Nicotine Replacement Therapy Protocol is Eligible for Clinical Services Reimbursement to Pharmacies.
Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.