Guidance on MPW Chiropractic or Podiatry PAs

Medicaid for Pregnant Women (MPW) Chiropractic or Podiatry Prior Approvals (PAs) are authorized for the number of units requested on the referral, not to exceed 60 calendar days. If the 60-day period has not elapsed, but the all units  have been used and services are still needed, the provider must submit a Continuation of Care PA request.  When submitting a Continuation of Care PA, the provider must include a letter with the new PA request with the authorization number of the previous PA and request the previous PA be end-dated the date after the last day the beneficiary was seen by the provider.  The dates on the original PA request and the Continuation of Care PA request may not overlap. 

For example:

  • A provider has an approved PA for a recipient for January 2, 2017, through March 2, 2017.
  • All units shown on the PA were used by February 20, 2017 and services are still needed.
  • The recipient was seen by the provider on February 20, 2017, and the provider determined services are still needed.
  • Action Required: The provider must enter a new Continuation of Care PA request on the NCTracks Provider Portal and (1) upload/attach a letter requesting that the current PA be end dated on the last date the recipient was seen, (2) submit a new referral from the OB provider indicating the PA begin date and units needed.

For tips on MPW Chiropractic and Podiatry PA, see the April 27, 2016, announcement on the NCTracks provider portal.