Reminder of Important System Changes Coming to NCTracks

Providers are reminded of the previously announced system changes scheduled to occur July 31, 2022.

 

Addition of Rehabilitation/Substance Use Taxonomy 261QR0405X

On July 31, 2022, behavioral health providers will be able to enroll with taxonomy 261QR0405X (Rehabilitation/Substance Use) for North Carolina Medicaid and NC Health Choice participation in addition to providers enrolling through Division of Mental Health (DMH) programs. This taxonomy is being enacted retroactively for Medicaid and NC Health Choice providers; providers may back-date their applications for this taxonomy to as early as July 31, 2021, for coverage of services previously rendered under this taxonomy.

The taxonomy is valid for participation by in-state, out-of-state and border area providers. To qualify for participation, a provider must be actively enrolled in Medicare as confirmed through Provider Enrollment, Chain and Ownership System (PECOS) using the current Medicare verification process. If a provider is not actively participating with Medicare, verification of active Substance Abuse and Mental Health Services Administration (SAMHSA) certification from Oct. 23, 2018, and later must be provided.

This taxonomy will be covered only for Health Care Procedure Coding System (HCPCS) code H0020 through the following Benefit Service Groups (BSGs):

  • NCXIX – North Carolina Title XIX
  • SCHIP – State's Children's Health Insurance Program
  • MCSTD – Medicaid Standard
  • HCSTD – Health Choice Standard

 

Designation Form No Longer Required for Current DEA Certifications

Effective July 31, 2022, functionality will be added to NCTracks to allow Drug Enforcement Administration (DEA) Certifications to be automatically loaded into the NCTracks system. Providers completing an initial enrollment, re-enrollment or manage change request (MCR) application with their DEA Certification will no longer be required to submit their DEA license as described in the previous workaround process; instead, providers will only need to enter their DEA Certification number on the application for NCTracks to verify. 

For existing providers enrolled with their DEA Certification, NCTracks will automatically update their DEA Certification expiration date going forward. However, if the DEA number changes, an MCR is required to report the change to the NCTracks provider record so the credential update will occur as intended.

If a provider designated as a prescriber on the Provider Permission Matrix (PPM)* does not have a DEA certification, they must still complete the DEA Designation Form as described in the previous announcement.

*The PPM may be found under Quick Links on the Provider Enrollment page.

 

Additional Electronic Visit Verification Data Capture

Effective July 31, 2022, NCTracks will capture additional Electronic Visit Verification (EVV) data from NC Medicaid’s EVV vendor, Sandata. EVV data capture will be expanded to include Bill Time and Pay Time for applicable claims to determine the applicable Personal Care Services (PCS) code units. NCTracks will capture and store these additional fields. 

For more information on this program, please see NC Medicaid’s EVV webpage.

 

Endoscopy Code Family Updated in NCTracks

NC Medicaid has updated endoscopy codes, aligning base codes with related procedures in the same family as well as creating one new endoscopy family. These updates are effective in NCTracks on July 31, 2022. The newly created endoscopy family may be found here.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M22213-R-2504-2585-2546-2552