Expanding Pilot Eligibility to Members in NC Medicaid Direct in Pilot Regions
Topics Related to All Providers
States must revalidate the enrollment of all providers at least every five years to ensure the information on record is accurate and current.
The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Recent State Plan Amendment outlines duties of a responsible third party
New separately reimbursable CPT codes in the ambulatory surgery setting
Providers should work with their Medicaid beneficiary’s health plan and Tailored Care Manager to transition the members to 1915(i) services.
Revised policy in addition to services outlined in Maternity Coverage and Reimbursement Bulletin posted Oct. 23, 2023.
Highlights from Year 2
The next review panel meeting is April 11, 2024