Medicaid Bulletin

CPT Code Update: 2021

Tuesday, March 2, 2021

Effective with date of service Jan. 1, 2021, the Centers for Medicare & Medicaid Services has identified new CPT and HCPCS codes as separately reimbursable in the ambulatory surgery setting.

NC Medicaid Help Center Now Available: A Convenient Way for Providers to Find Information

Monday, March 1, 2021

In addition to the NC Medicaid Provider webpage, Medicaid and NC Health Choice providers now have a supplemental resource to research their questions and submit inquiries.

Transition of Care Policy for Prepaid Health Plans Under the Standard Plan Option Released

Friday, February 26, 2021

NC Medicaid has released the NC Department of Health and Human Services Transition of Care Policy, which outlines NC Medicaid's vision on the process of assisting a beneficiary through the transition between health plans or between service/payment delivery systems.

Advanced Medical Home Provider Manual 2.0 Released

Friday, February 26, 2021

The Department released the Advanced Medical Home Provider Manual 2.0 today. This version reflects program expectations as well as recent program modifications and changes that impact provider contracts.

Personal Care Services Policy 3L, Implementation of Electronic Visit Verification, Public Comment Period Extended

Wednesday, February 24, 2021

The public comment period has been extended through March 15, 2021, for Personal Care Services Policy 3L, Implementation of Electronic Visit Verification.

SPECIAL BULLETIN COVID-19 #158: Correction to COVID-19 Lab Code 87428

Friday, February 19, 2021

CPT Code 87428 (related to COVID-19) was improperly defined in a previous Bulletin and is being correctly defined here. 

Community Alternatives Program for Children (CAP/C) Waiver Renewal Stakeholder Engagement

Tuesday, February 16, 2021

The Community Alternatives Program for Children (CAP) §1915(c) Home- and Community-Based Services (HCBS) waiver will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.  

Billing Code Update for Nurse Practitioners and Physician Assistants

Tuesday, February 16, 2021

North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).

Tailored Care Management Certification Deadline Extended to June 1, 2021

Monday, February 15, 2021

To continue supporting providers interested in obtaining certification as an Advanced Medical Home Plus (AMH+) practice or Care Management Agency (CMA),the Round 1 application deadline is being extended from March 1, 2021 to June 1, 2021. 

SPECIAL BULLETIN COVID-19 #157: Final Reconciliation of Nursing Home Staff Testing Payments Authorized Under Secretarial Orders 2 and 4

Monday, February 15, 2021

NC Medicaid is initiating its final phase of reconciling projected versus actual testing cost submission activity for nursing home staff testing payments authorized under Secretarial Orders 2 and 4 on March 1, 2021. 

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