Clinics include certified rural health clinics, federally qualified health centers and local health departments.
Refer to DMA’s website at http://www.dhhs.state.nc.us/dma/mp/mpindex.htm, for specific coverage criteria, prior approval requirement, and service limitations.
Core services are covered by both Medicare and Medicaid. The service must be a face-to-face encounter between the recipient and the provider in the clinic or the recipient's home.
REVISED 08/01/11 – CHANGE NO. 14-11
Outpatient clinic visits count towards a recipient’s 22 mandatory and 8 optional annual medical professional services visits, except as noted in II.A. Multiple diagnostic visits on the same date of service count as one visit.
$3.00 for brand name
It is the provider's responsibility to obtain prior approval if needed. Refer to II.G.
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.