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Medicaid Bulletin

Update to Clinical Policy 15 Ambulance Services

Tuesday, September 3, 2019

Session Law 2018-5 Sec.11H.4 (see Appendix A) instructed the NC Department of Health and Human Services (DHHS) to submit to Centers for Medicare and Medicaid Services (CMS) for the necessary authority to establish Medicaid reimbursement for ambulance transports of Medicaid beneficiaries in behavioral health crisis to behavioral health clinics or other alternative locations effective July 1, 2019.

NC’s Transition to Medicaid Managed Care: The Crossover Communication Series

Tuesday, September 3, 2019

Supporting beneficiaries in their transition between the current fee-for-service delivery system and NC Medicaid Managed Care is called transition of care. The transitional period surrounding the launch of Medicaid Managed  Care is referenced as crossover.

Billing Code Update for Nurse Practitioners and Physician Assistants

Tuesday, September 3, 2019

NC Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs). NC Medicaid has provided instructions to NCTracks on updating the claims processing system.

Clinical Coverage Policy Update

Tuesday, September 3, 2019

Several new or amended clinical coverage policies are available on NC Medicaid’s website.

Clinical Coverage Policy Update

Thursday, August 1, 2019

Policies (9) Outpatient Pharmacy Program and (8F) Research-based Behavioral Health Treatment (RB-BHT) for Autism Spectrum Disorder (ASD) are available on NC Medicaid's website.

Clinical Coverage Policy Update: 1A-12 Breast Surgeries

Thursday, August 1, 2019

Clinical Coverage Policy 1A-12 Breast Surgeries has been updated to reflect changes throughout the policy.

Updates to NC Medicaid Electronic Health Record (EHR) Incentive Program

Thursday, August 1, 2019

The NC Medicaid EHR Incentive Payment System (NC-MIPS) is only accepting Program Year 2019 Stage 3 Meaningful Use (MU) attestations.

Sterilization Consent Form

Thursday, August 1, 2019

The sterilization consent form found on the U.S. Department of Health & Human Services (HHS) website has been updated.

New Coverage for Low-Dose Lung Cancer Screening

Thursday, August 1, 2019

Effective July 1, 2019, providers may request, perform and bill for low-dose lung cancer screening utilizing healthcare common procedure coding system (HCPCS) code G0297. 

Introducing NC’s Transition to Medicaid Managed Care: The Crossover Communication Series

Thursday, August 1, 2019

Supporting beneficiaries in their transition between the current fee-for-service delivery system and NC Medicaid Managed Care is called transition of care. The transitional period surrounding the launch of Medicaid Managed Care is referenced as crossover.

DHHS will initiate crossover-specific activities in August 2019 and will continue these activities through April 2020.

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