New Medicaid Bulletin Articles Available as of Dec. 15

The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:

• Rezafungin for Injection, for Intravenous Use (Rezzayo™) HCPCS Code J3490 - Unclassified Drugs: Billing Guidelines- Effective with date of service July 31, 2023, NC Medicaid covers rezafungin for injection, for intravenous use (Rezzayo)
• Pegunigalsidase Alfa-Iwxj Injection, for Intravenous Use (Elfabrio®) HCPCS Code J3590 - Unclassified Biologics: Billing Guidelines- Effective with date of service June 14, 2023, NC Medicaid covers pegunigalsidase alfa-iwxj injection, for intravenous use (Elfabrio).
• Glofitamab-Gxbm Injection, for Intravenous Use (Columvi™) HCPCS Code J9999 - Not Otherwise Classified, Antineoplastic Drugs: Billing Guidelines- Effective with date of service June 27, 2023, NC Medicaid covers glofitamab-gxbm injection, for intravenous use (Columvi)
• Efgartigimod Alfa and Hyaluronidase-Qvfc Injection, for Subcutaneous Use (Vyvgart® Hytrulo) HCPCS code J3590 - Unclassified Biologicals: Billing Guidelines- Effective with date of service July 11, 2023, NC Medicaid covers efgartigimod alfa and hyaluronidase-qvfc injection
• COVID-19 Vaccine and Reimbursement Guidelines for 2023-2024 for NC Medicaid- This bulletin replaces NC Medicaid COVID-19 Vaccine and Reimbursement Guidelines for 2023-2024
• Beremagene Geperpavec-Svdt Biological Suspension Mixed with Excipient Gel for Topical Application (Vyjuvek™) HCPCS Code J3590 - Unclassified Biologics: Billing Guidelines- Effective July 15, 2023, NC Medicaid covers beremagene geperpavec-svdt biological suspension mixed with excipient gel for topical application
• Point-of-Sale (POS) Vaccine Reimbursement Updates- NC Medicaid will begin publishing the POS vaccine rate file in January of 2024

Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.