Medicaid Bulletin

Medicaid is adding codes into NCTracks to report negative pressure wound therapy utilizing disposable, non-durable medical equipment.

NCTracks continues sending notifications of suspension to providers through the Provider Message Center Inbox for failure to update expiring credentials. 

Effective for dates of service on or after July 1, 2021, prior approval for high tech imaging services will no longer be required for North Carolina Medicaid Direct beneficiaries.

NC Medicaid will sunset its CARES Act funded reimbursement of nursing facility staff COVID-19 testing in June 2021. This bulletin provides an update on processing timelines for previously submitted cases and provides additional guidance for final payments under this initiative.

Revisions have been made to Clinical Policy 1A-20, Sleep Studies and Polysomnography Services effective May 1, 2021.

Effective June 1, 2021, claims submitted for personal care-type services for Medicaid beneficiaries in CAP/C and CAP/DA programs must have EVV data on file in NCTracks to bypass the EVV edits of 02077 and 02079 to assist with claim adjudication. 

DHHS will hold a webinar on June 4, 2021, to provide an update on the development of the Specialized Foster Care Plan. 

Topics include: key dates, contracting reminders, provider ombudsman, playbook updates, outreach to patient panels, webinars, provider directory, PHP quick reference guides, Help Center and Tailored Care Management certification.

NC DHHS announced the selection of organizations to serve three regions of the state

To ensure providers meet contractual obligations to keep credentials current, notifications of suspension for failure to update a credential prior to the expiration date on file with NCTracks were implemented in May.