Medicaid Bulletin

NC Medicaid is temporarily adding Telemedicine and Telepsychiatry clinical coverage codes for specialty providers and increasing reimbursement rates for telephonic visits and primary care medical home per member per month fees to help primary and specialty care providers continue to serve patients during the COVID-19 emergency.

NOTE: SPECIAL BULLETIN COVID-19 #79 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #103. This Bulletin clarifies that skilled nursing facilities (SNF) are eligible originating sites for telemedicine visits and enables such facilities to bill for a facility fee when a beneficiary located in a SNF receives care via telemedicine from an eligible remote provider.  

Update (May 8, 2020)

• Bulletin #78 includes information that Local Health Department (LHDs), Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes and Rural Health Clinics (RHCs) may use, as out

NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid and Health Choice beneficiaries.

Effective April 30, 2020, NC Medicaid in partnership with the DHHS Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability (I/DD) Clinical Coverage Policies to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic.

Effective April 30, 2020, NC Medicaid in partnership with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability (I/DD) Clinical Coverage Policies to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic. 

NC Medicaid is temporarily increasing financial assistance to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to support them in maintaining critical access to care for Medicaid beneficiaries during the COVID-19 emergency.

Effective May 1, 2020, Liberty Healthcare of North Carolina will resume completion of annual assessments. SPECIAL BULLETIN COVID-19 #30: Personal Care Services Assessments also indicated that annual assessments due would have Prior Approvals extended for a minimum of 90 days. 

NC Medicaid has adjusted home health requirements currently in Home Health Clinical Coverage Policy No: 3A to align with a CMS regulatory change focused mostly on changes to the Medicare policy addressing COVID-19.

NC Medicaid temporarily suspended the requirement of Level I and Level II Preadmission Screening and Resident Reviews (PASRRs) for new nursing home admissions as well as the requirement of a PASRR number on the prior approval (PA).  The temporary suspension was due to COVID-19 and was in effect from March 25 – April 24, 2020, as noted in SPECIAL BULLETIN COVID-19 #15: Medicaid and NC Health Choice Temporary Flexibilities - 1135 Waiver Provisions.