Medicaid Bulletin

Electronic Visit Verification and In-Home Caregivers

Wednesday, December 16, 2020

Clarification regarding Electronic Visit Verification (EVV) and how it applies to in-home caregivers, including service codes for EVV and frequently asked questions on this topic.

Third-Party Liability Medicaid and NC Health Choice Billing Guide

Tuesday, December 15, 2020

The latest version of the Third-Party Liability Medicaid and NC Health Choice billing guide is available.

Registered Dieticians and Nutritionists Added to the List of Eligible Providers

Tuesday, December 15, 2020

Effective July 26, 2020, Registered Dieticians and Nutritionists may enroll in Medicaid or the NC Health Choice program to provide and bill for this service for pregnant women and beneficiaries less than 21 years of age.  

Meningococcal [Groups A, C, Y, W] Conjugate Vaccine, Solution for Intramuscular Injection (MenQuadfi™) CPT Code 90619: Billing Guidelines

Tuesday, December 15, 2020

Effective with date of service Nov. 13, 2020, the Medicaid and NC Health Choice programs cover meningococcal [Groups A, C, Y, W] conjugate vaccine, solution for intramuscular injection (MenQuadfi™) for use in the Physician Administered Drug Program. 

Medicaid Managed Care PCP Auto-Assignment Changes Based on Evidence of Active Beneficiary Treatment Relationship

Tuesday, December 15, 2020

As Medicaid and NC Health Choice transition to managed care, beneficiaries will be notified to select a Prepaid Health Plan as well as a Primary Care Provider/Advanced Medical Home. Beneficiaries who do not self-select will be auto assigned by the Department. 

Famotidine Injection (Pepcid®) HCPCS Code J3490: Billing Guidelines

Tuesday, December 15, 2020

Effective with date of service Jan. 1, 2020, the Medicaid and NC Health Choice programs cover famotidine injection (Pepcid®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Clinical Policy 1E-3, Sterilization Procedures – Claim Denials

Tuesday, December 15, 2020

Claim Denials for Sterilization CPT Code 58661

Clinical Policy 1E-3, Sterilization Procedures - Sterilization Consent Form

Tuesday, December 15, 2020

Updates on the consent form expiration date and clarifications related to the Aug. 15, 2020 policy update.

Amisulpride Injection, for Intravenous Use (Barhemsys®) HCPCS Code J3490: Billing Guidelines

Tuesday, December 15, 2020

Effective with date of service Aug. 4, 2020, the Medicaid and NC Health Choice programs cover amisulpride injection, for intravenous use (Barhemsys®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.

Application Period Open for Tailored Care Management Certification

Monday, December 14, 2020

The Tailored Care Management certification process is now open, and providers may submit applications.

Subscribe to Medicaid Bulletins Updates

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Associated Files