This plan amendment adds reimbursement methodology for an ambulatory surgical center being used to provide dental services.  

This SPA will amend the State Plan pursuant to North Carolina Disaster State Plan Amendment (SPA) 20-0016 and will revise the methodology to include (a) an update to 2018 as the cost report base year for determining provider specific Prospective Payment System (PPS) rates and (b) adding an Alternative Payment Methodology (APM) in compliance with CMS Companion Letter to North Carolina Disaster Relief State Plan Amendment (SPA) 20-0016.
 

This amendment updates the state plan to reflect that Brokered Non ­Emergency Medical Transpo1iation (NEMT) Services are now provided through two Regional Transit Authorities. 

This amendment proposes to change provider requirements for community mental health centers, adds coverage of prophylaxis under the state’s dental benefit, allows for 90-day coverage of maintenance medications, and adds weight loss drugs to the state’s prescription drug formulary. 

CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the reimbursement rate for the administration of in-home COVID-19 vaccinations (HCPCS M0201) for homebound individuals from the Medicare geographically adjusted Ohio rate of $33.36 to $62.02 when billed with an SY modifier.