NC Medicaid Authorizes Temporary Telephonic E/M Services for Influenza

The North Carolina Division of Medical Assistance (DMA) is offering telephonic evaluation and management services (E/M) to Medicaid beneficiaries who are actively experiencing flu-like symptoms to help respond to the higher than normal number of influenza cases this flu season.

This service is intended to help physicians and physician assistants assess established patients over the telephone to gather additional information. Telephonic E/M services are not to be billed if the patient needs to be seen within 24 hours for an office visit or next available appointment. In those circumstances, the telephone consultation shall be considered a part of the office visit.

Dates of service for reporting of telephonic E/M codes coincide with the annual flu season. Claims for telephonic calls related to flu-like illness will be denied for dates of service after April 30, 2018. See NC DMA’s Special Bulletin for more information.


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