Medicaid Bulletin

Updates to Clinical Coverage Policy 10C, Outpatient Specialized Therapies, Local Education Agencies (LEAs)

Tuesday, January 12, 2021

An amended version of Clinical Coverage Policy 10C, Outpatient Specialized Therapies, Local Education Agencies (LEAs) with an effective date of Jan. 1, 2021, was posted to the NC Medicaid Specialized Therapies Clinical Coverage Policies web page.

Quarterly HCPCS Code (J Codes) Update - January 2021

Tuesday, January 12, 2021

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

Dual Special Needs Plan Data Sharing of Hospital and Skilled Nursing Facility Admissions

Tuesday, January 12, 2021

Effective Jan. 1, 2021, many D-SNPs will be required to notify the state Medicaid agencies they contract with (or the state's designee) when their enrollees are admitted to a hospital or skilled nursing facility.

SPECIAL BULLETIN COVID-19 #148: Pfizer-BioNTech COVID-19 Vaccine (N/A) HCPCS Code 91300: Billing Guidelines

Wednesday, January 6, 2021

Effective with date of service Dec 12, 2020, the Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine for use in the Physician Administered Drug Program. 

[Coagulation Factor VIIa (Recombinant)-jncw] Lyophilized Powder for Solution, for Intravenous Use (Sevenfact®) HCPCS Code J7212: Billing Guidelines

Tuesday, January 5, 2021

Effective with date of service Jan 1, 2021, the Medicaid and NC Health Choice programs cover [coagulation factor VIIa (recombinant)-jncw] lyophilized powder for solution, for intravenous use (Sevenfact®) for use in the Physician Administered Drug Program. 

Pegfilgrastim-apgf Injection, for Subcutaneous Use (Nyvepria™) HCPCS Code Q5122: Billing Guidelines

Tuesday, January 5, 2021

Effective with date of service Jan 1, 2021, the Medicaid and NC Health Choice programs cover pegfilgrastim-apgf injection, for subcutaneous use (Nyvepria™) for use in the Physician Administered Drug Program.

NC Medicaid Electronic Health Record Incentive Program Announcements

Tuesday, January 5, 2021

NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.

Interim CIAE Referral Process to Participate in Community Alternatives Programs

Tuesday, January 5, 2021

An independent review of referrals for individuals seeking to enroll in the Community Alternatives Program for Children and Disabled Adults (CAP/C and CAP/DA) waivers is intended to provide an unbiased assessment to ensure the enrollment processes are executed appropriately in each waiver application. 

Ferric Derisomaltose Injection, for Intravenous Use (Monoferric™) HCPCS Code J1437: Billing Guidelines

Tuesday, January 5, 2021

Effective with date of service Oct. 2, 2020, the Medicaid and NC Health Choice programs cover ferric derisomaltose injection, for intravenous use (Monoferric™) for use in the Physician Administered Drug Program.

CPT Code Update 2021

Tuesday, January 5, 2021

Effective with date of service Jan. 1, 2021, the American Medical Association has added new CPT codes, deleted others, and changed the descriptions of some existing codes.  

Subscribe to Medicaid Bulletins Updates

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Associated Files