Click here to read the bulletin for June 2012
The purpose of this notice is to announce that the mandatory implementation of this change will be delayed to address administrative procedures and to allow more time to do outreach to affected provider communities.
As a reminder, 42 CFR, subpart E, 455.410 (b) requires:
“the state Medicaid agency must require all ordering or referring physicians or other professionals providing services under the State plan or under a waiver of the plan to be enrolled as participating providers.”
Both NPs and PAs should continue their current billing method. NPs and PAs not enrolled with N.C. Medicaid should begin the enrollment process and may continue billing “incident to” until further notice. DMA will monitor the enrollment of NPs and PAs and will notify providers when they should begin using the NPI as the rendering/attending provider number. The effective date of any change to the current “incident to” policy will be communicated to providers via bulletin articles, Website updates, and provider e-mail blasts.
Delay of Required Enrollment for Physician Assistants and Nurse Practitioners
The N.C. Division of Medical Assistance (DMA) announced in the May 2012 Medicaid Bulletin that Nurse Practitioners (NP) and Physicians Assistants (PA) must enroll in the N.C. Medicaid Program and all services rendered by those healthcare providers must be filed with N.C. Medicaid using their National Provider Identifier (NPI) as the rendering (or attending) provider.The purpose of this notice is to announce that the mandatory implementation of this change will be delayed to address administrative procedures and to allow more time to do outreach to affected provider communities.
As a reminder, 42 CFR, subpart E, 455.410 (b) requires:
“the state Medicaid agency must require all ordering or referring physicians or other professionals providing services under the State plan or under a waiver of the plan to be enrolled as participating providers.”
Both NPs and PAs should continue their current billing method. NPs and PAs not enrolled with N.C. Medicaid should begin the enrollment process and may continue billing “incident to” until further notice. DMA will monitor the enrollment of NPs and PAs and will notify providers when they should begin using the NPI as the rendering/attending provider number. The effective date of any change to the current “incident to” policy will be communicated to providers via bulletin articles, Website updates, and provider e-mail blasts.
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