North Carolina DHHS Medicaid LME/MCO Communication Bulletin #J103: Medical Detoxification Billing

This notice was issued October 31, 2014, by the North Carolina Department of Health and Human Services. The notice reminds North Carolina’'s nine non-profit public behavioral health managed care organizations (MCO) that they are responsible for paying hospital charges related to detoxification services for Medicaid beneficiaries. The MCO per member per month (PMPM) capitation rate includes all claims on a psychiatric Diagnosis-Related Group (DRG), which encompasses “medical detoxification.” The MCOs are also responsible for follow-up and aftercare of these beneficiaries . . .