Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Clinical Coverage Policy Update 1T-2, Special Ophthalmological Services
Effective Jan. 1, 2026, NC Medicaid has amended Clinical Coverage Policy 1T-2.
Behavioral Health Clinical Coverage Policy Updates
Promulgation of New Clinical Coverage Policies and Amendment to Clinical Coverage Policy 8A Enhanced Mental Health and Substance Abuse Services.
2A-1 Acute Inpatient Hospital Services Policy Update
Effective Jan. 1, 2026, The Acute Inpatient Hospital Services policy has been revised.
Updated Coverage for Psychiatric Collaborative Care Management – December 30, 2025
Coverage for Healthcare Common Procedure Coding System Code G0512 is end-dating effective Dec. 31, 2025.
2026 Current Procedure Terminology Code Update
Effective with date of service Jan. 1, 2026, new Current Procedure Terminology (CPT) codes have been added or deleted, and descriptions of some existing codes have been updated.
Updates to Clinical Coverage Policy 1S-11: Genetic Testing Gene Expression
Clinical Coverage Policy 1S-11 will include coverage for AlloMap® effective Jan. 1, 2026.
Individual Ordering Provider NPI Must Be Included on Drug Testing Claims
Effective for dates of service on or after Feb. 1, 2026, claims for certain drug testing procedure codes must include an individual ordering provider NPI.
2026 Community Alternatives Program Consumer Direction Schedule of Trainings
The 2026 initial training dates for Community Alternatives Program consumer direction are now available.
Non-Emergency Medical Transportation Rate Reduction Update
NC Medicaid is advising of a phased-in process for the reinstatement of non-emergency medical transportation rates to those in effect Sept. 30, 2025.
NC Medicaid to Reinstitute Coverage of GLP-1s for Weight Management
Effective Dec. 12, 2025, coverage for GLP-1s for the treatment of obesity will be reverted to the coverage available as of Sept. 30, 2025.