Medicaid Bulletin

Articles published prior to January 2018 are available in the Medicaid Bulletin Archive.

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Bendamustine Hydrochloride Injection, for Intravenous Use (Baxter) HCPCS Code J9999 - Not Otherwise Classified, Antineoplastic: Billing Guidelines
Effective with date of service Jan. 30, 2023, the Medicaid and NC Health Choice programs cover bendamustine hydrochloride injection, for intravenous use (Baxter).
Sterilization Procedures for Hospital Providers
In compliance with federal requirements, beneficiary consent is required for all voluntary sterilizations.
Electronic Visit Verification Required for Home Health Care Services
Effective immediately, all providers must use the Electronic Visit Verification vendor of their choice for every home health visit.
Ambulatory Blood Pressure Monitoring Coverage
Effective April 1, 2023, NC Medicaid covers ambulatory blood pressure monitoring. This helps confirm or exclude suspected hypertension.
Supervision Requirements of Board-Certified Behavior Analysts
Clarifies requirements related to Research Based-Behavioral Health Treatment and Specialized Consultative Services and New Taxonomy
Updated Guidance for Private Duty Nursing
Physician’s signature on the CMS 485 Plan of Care form
Overpayment Recovery Reviews
Providers are required to make adequate provision for return of any money incorrectly collected 
Clinical Coverage Policy 1A-39, Routine Patient Costs Furnished in Connection with Participation in Qualifying Clinical Trials
CCP 1A-39 has been updated to reflect changes in 1905(a) of the Social Security Act
NC Medicaid Managed Care Provider Update – April 21, 2023
Provider reverification, Tailored Plans start date Oct. 1, upcoming key milestones, playbook updates, billing requirement modifications and more.
NC Medicaid CAP/C Waiver Renewed through 2028
The waiver has received approval for another five years through Feb. 29, 2028.