Effective January 1, 2021, NC Medicaid and NC Health Choice is temporarily covering Healthy Opportunities screenings to encourage providers to gain capacity for screening Medicaid beneficiaries for unmet health-related resource needs and referring them to appropriate community-based resources, prior to the launch of Medicaid managed care.
Current Carolina Access (CAII) providers are eligible to bill code G9919 for positive healthy opportunities screenings conducted using the Department’s standardized screening questions. Coverage of this code will continue through June 30, 2021; continued coverage after managed care launch will be at the discretion of the Health Plans.
To claim reimbursement for positive Healthy Opportunities screenings under the HOSAR payment program, providers completed the screening using the Department’s standard screening questions or an equivalent instrument with similar questions covering beneficiary needs related to the Department’s four priority domains:
– Food insecurity – Housing instability – Lack of transportation – Interpersonal violence
Standard screening questions are available at https://www.ncdhhs.gov/about/department-initiatives/healthy-opportunities/screening-questions
Positive screenings are screenings with one or more “yes” answers in at least one of the four Healthy Opportunities domains
Please see DHHS website for more information about HOSAR:
