From NC Medicaid:

Some private and commercial insurers already require these codes, so providers should check with their billing team to review relevant protocol. These F codes are required by NC Medicaid’s clinical policy and apply to all delivery claims (not just those that are globally billed).

NC Medicaid urges providers to begin using the new codes as soon as possible. After July 1, 2025, Medicaid claims for delivery will deny if 0500F is not in the patient's history. This change will apply to both NC Medicaid Managed Care and NC Medicaid Direct claims.

Details and Source: New F Codes: Capturing Prenatal and Postpartum Care Services

Most eligible children will automatically qualify for the program and were auto enrolled by May 2, 2025. Children automatically qualify if they are eligible for any of the following programs: 

• Free and reduced-price (FRP) meals at schools by approved FRP application
• Food and Nutrition Services (also called FNS or food stamps)
• Temporary Assistance for Needy Families (TANF)
• Cherokee Tribal Food Distribution Program (CTFDP)
• Child is in Foster Care
• Child is enrolled in the McKinney-Vento program (experiencing homelessness or runaway)
• OR if they receive NC Medicaid benefits and have a household income below 185% of the federal poverty level

Families with children who qualify will receive a new 2025 SUN Bucks card in the mail.  

Families with questions can visit the website at ncdhhs.gov/sunbucks or call the NC SUN Bucks Call Center at 1-866-719-0141, select a language, then select option 2 to speak with a SUN Bucks representative.

See the full Press Release from NCDHHS to learn more.

From the North Carolina Office of Rural Health:

The Office of Rural Health (ORH) offers qualifying physicians, with educational (student) loan debt, incentive payments to repay their loans tax-free through the Primary Care Physicians Initiative (NC PCPI). With the passage of Session Law 2023-134, incentive payments are awarded to eligible physicians in exchange for providing comprehensive primary care services in outpatient settings at eligible sites serving those with highest need located within Tier 1 and Tier 2 of the North Carolina's County Distress Rankings (Tiers).

Funding is limited and the awards will be based on a first-come, first-served basis for eligible and complete applications. ORH anticipates up to 16 awards in each of the six Medicaid Regions. The application portal will not accept more than 20 applications per Medicaid Region. 

Applicants are strongly encouraged to review the guidelines carefully and gather necessary documentation so that they are prepared to complete the online application in its entirety via the application portal.

MEDICAID MANAGED CARE BACK PORCH CHAT

Key NC Medicaid Updates

Thursday, May 15 | noon-1 p.m.

Please join this month's Back Porch Chat on Thursday, May 15 from 12-1 p.m. This webinar will be hosted by Dr. Janelle White, Chief Medical Officer of NC Medicaid, and will cover important federal updates and NC Medicaid budget priorities.

Additional topics include:

• Clinical Coverage Request Process and Policy Revision Request Process
• 2024 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Results
• Credentialing Committee Updates
• Justice-Involved Reentry Work

Register by clicking the blue button below. We look forward to connecting with you!

It's National Kidney Month!

Chronic kidney disease affects nearly 37 MILLION people in the country (more than 1 in 7 adults). 

Chronic kidney disease often causes no symptoms until it is more advanced.

Chronic kidney disease is progressive.

Chronic kidney disease puts people at risk for other serious health problems like heart attack, stroke and kidney failure.

One in three adults with diabetes (and one in five with hypertension) may have chronic kidney disease (CKD).

90% of people with it DO NOT KNOW THEY HAVE kidney disease!

Back to our title, "it takes two to make a thing go right": Two tests should be done to look for CKD. Fewer than half of patients at high risk for CKD are screened appropriately.

How to screen?

• Spot urine ACR (albumin-to-creatinine ratio)

AND

• eGFR (estimated Glomerular Filtration Rate)

Get started now to help make this thing go right!

With funding from NCDHHS, Project AWARE is able to offer SBIRT (Screening, Brief Intervention, and Referral to Treatment) training via Appalachian State University at no cost to the first 300 applicants!

SBIRT

• is brief
• is comprehensive
• decreases the severity of drug and alcohol use (early intervention with SBIRT saves lives and money and is consistent with overall support for patient/client wellness)
• reduces health care costs
• is used in various settings (by doctors, nurses, social workers, psychologists, counselors and other service providers)

Users of this technique employ a variety of tools including AUDIT (Alcohol Use Disorder Identification Test), DAST (Drug Abuse Screening Test) and CRAFFT (Adolescent Screening Tool). Motivational Interviewing is at the core of SBIRT training.

There are two components to this free training; online asynchronous modules and a synchronous workshop. 

You can also register here.

MEDICAID MANAGED CARE

Virtual Office Hours

NC Medicaid Initiatives & Updates

Thursday, March 6 | noon-1 p.m.

Please join us on Thursday, March 6 from noon-1 p.m. to hear about NC Medicaid initiatives and updates, including:

• Education/Training Transcripts
• New Ordering/Prescribing/Referring Provider Guidelines
• Delegated Enrollment & Credentialing Committee
• Telehealth
• Annual Federal Fee Increase 
• Children & Family Specialty Plan Update
• Multi-Factor Authentication/NCID Update

Register by clicking the blue button below. We look forward to connecting with you!

These learning collaboratives are for primary care providers, behavioral health professionals, and anyone else who has implemented or is considering the Collaborative Care Model (CoCM) for integrating behavioral health in a primary care setting. Independent primary care practices, FQHCs, and rural health clinics may find this collaborative especially helpful for meeting some of the behavioral health needs of their patients.

The next session is February 20 from noon-1 PM.

Check out the attached flyer for more details and to register for one or more sessions!

Register now for the next AHRQ (Association for Healthcare Research and Quality) webinar to be held on March 6 from 2:00-3:15 PM eastern.

This webinar will highlight the role of primary care in perinatal care with research on:

• Delivering respectful maternity care
• Insurance disruptions on maternal healthcare
• Postpartum primary care coordination for people with multiple chronic conditions and how they might impact patient outcomes

There will be a Q & A session after the presentations.

Advanced registration is required. You can also register for all upcoming webinars in this series.

Check out these other programs offered by NWAHEC:

• Basic Fetal Monitoring - Spring 2025
  April 9th, 9AM-3PM
  LIVE WEBINAR
  Learn more and register here
  
  
• Basic Fetal Monitoring - Fall 2025
  October 1st, 9AM-3PM
  IN-PERSON at Wake Forest Biotech Place
  Winston-Salem, NC
  Learn more and register here
  
  
• 2025 North Carolina Lactation Educator Training Program
  The 2025 North Carolina Lactation Educator Training Program consists of online self-paced training modules and a separate in-person skills day. Learn More and Register
  
  
• 13th Annual Breastfeeding Forum
  March 18th, 9AM-3PM
  In Person at Hickory Metro Center
  Learn more and register here
  
  

What evidence is available to support use of artificial intelligence systems in primary care?