Happy Tuesday! Enjoy your NCMS Morning Rounds.

September 28, 2021

Temporary Availability of the Hospital at Home Program

Effective Sept. 1, 2021, the Acute Hospital Care at Home (HAH) program will be available to North Carolina hospitals that have been granted a waiver from CMS and service NC Medicaid beneficiaries. NC Medicaid is planning to implement this program to be effective Sept. 1 through Dec. 31, 2021, unless this flexibility is terminated prior to Dec. 31, 2021.

The Acute HAH program is an expansion of the CMS Hospital Without Walls initiative as a part of a comprehensive effort to increase hospital capacity, maximize resources and combat COVID-19 to keep Americans safe. This program creates additional flexibility that allows for certain health care services to be provided outside of a traditional hospital setting and within a patient’s home.

Read full SPECIAL BULLETIN COVID-19 #182 here.

COVID-19 Vaccine Home Administration

Medicaid will pay an extra $35, in addition to the standard administration payment (approximately $40 per COVID-19 vaccine dose), for a total payment of approximately $75 for a vaccine dose administered in a patient’s home.

The additional payment applies when the COVID-19 vaccine is administered in Medicaid patients’ homes, under the following conditions:

  • Beneficiary has disability, illness, or injury, which makes travel difficult.
  • Beneficiary faces clinical, socioeconomic or geographical barriers to getting a COVID-19 vaccine in settings other than their home.
  • Beneficiary has a condition that makes them more susceptible to contracting COVID-19.

The following locations do NOT qualify as a home for the additional payment amount, regardless of whether it is the patient’s permanent residence:

  • Hospitals
  • Medicaid skilled nursing facilities (SNFs)

Medicaid will only pay the additional payment for administering the COVID-19 vaccine in the home if the sole purpose of the visit is to administer a COVID-19 vaccine.

Medicaid will follow all other applicable rules as set by CMS and in parity with Medicare rules for payment.

Place of service code on the claims must be 12 HOME.

M0201 MUST be billed with another COVID-19 vaccine administration code recognized and paid for by Medicaid (0001A, 0002A, 0003A, 0011A, 0012A, 0013A, 0031A).

CareMessage has Remaining Grant Funds for NC

CareMessage, a HIPAA-compliant patient messaging platform exclusively for FQHCs and the underserved, has two (2) grants available for North Carolina CHCs! These are first come, first serve, and don’t even require an application:  The first is specifically for North Carolina from BioGen.  This can be used to subsidize an agreement for the full platform up to 50 percent over 2 years. The second grant, Project Equity, would apply if at least 30 percent of the patients you serve are ethnic minorities. CareMessage would love to learn more about your organization, your patient engagement strategies, specific use cases, priorities, and challenges.

If interested in either opportunity, please contact:

Marywiley Pate ([email protected])
Phone: 770-778-9899

In the News

Study Explores Rare COVID-19 Related Inflammatory Disease In Adults, Becker’s, 9-23-21

Learning Opportunity 

Registration NOW OPEN for the 2021 Virtual LEAD Health Care Conference

The goal for the 2021 LEAD Conference is to bring the health care community together during what has proven to be one of the most challenging times. As the LEAD tagline suggests – Leadership, Education, Advocacy and Discovery – this conference will be oriented around sharing knowledge, perspectives, stories and ideas for health care and the practice of medicine for the future.  What can we learn from each other that will inspire, enrich, and provoke thoughts moving forward.

Some topics we will examine include:

  • Lessons learned during the COVID-19 pandemic;
  • Equity in medicine;
  • Well-being among health care professionals;
  • The commoditization of health care;
  • And much more, including our annual MEDTalks presentations, Virtual Scientific  Poster Session, and a Virtual North Carolina Medical Society Open House.

Don’t miss this opportunity to connect, learn and engage with your medical society and your colleagues! Learn more about what’s in store by viewing the Agenda online or downloading the meeting schedule (PDF).



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