Effective with date of service Feb. 1, 2021, the Medicaid and NC Health Choice programs cover cabotegravir extended-release injectable suspension; rilpivirine extended-release injectable suspension, co-packaged for intramuscular use (Cabenuva™).
Medicaid Bulletin
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Cabotegravir and Rilpivirine Co-Packaged for IM Use (Cabenuva™) HCPCS Code J3490: Billing Guidelines
NC Medicaid will extend the pay and report period for providers subject to Electronic Visit Verification (EVV) past the original cutoff date of March 31, 2021. Medicaid will provide 30 days’ notice prior to the conclusion of pay and report.
This Bulletin gives guidance on the use of EVV for the Community Alternatives Programs for Children and Disabled Adults (CAP/C and CAP/DA) to ensure compliance with Section 12006 of the 21st Century Cures Act.
NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through June 30, 2021.
This Bulletin updates rates previously published in SPECIAL BULLETIN COVID-19 #152 and SPECIAL BULLETIN COVID-19 #160. Effective March 15, 2021, NC Medicaid is aligning reimbursement for COVID-19 vaccine administration with the CMS increased Medicare rate of $40 per dose.
To support the DHHS goals to achieve health equity, NC Medicaid is introducing an enhanced payment to Carolina Access primary care practices serving beneficiaries from areas of the state with high poverty rates.
DHHS is releasing an addendum to the Tailored Care Management Provider Manual on community inclusion that addresses the in-reach and transition requirements for Advanced Medical Home Plus practices and Care Management Agencies delivering Tailored Care Management.
It has come to the attention of NC Medicaid that Edit 02088, which enforces a rule that coverage of procedure code G9919 for Healthy Opportunities Screening, Assessment and Referrals (HOSAR) positive screenings, be limited to providers affiliated with Carolina Access II based on the rendering provider NPI.
The implementation date of Electronic Visit Verification for LME-MCOs has been extended to June 30, 2021.
Key Dates for Transitioning to Medicaid Managed Care, PHP Quick Reference Guides Created, Provider Contracting Reminders, Provider Playbook Updates, Medicaid Contacts Reference Guide for Beneficiaries, Help Center, Webinars, Virtual Office Hours, Meet and Greet Sessions.