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23 <br /> NC Medicaid Medicaid and Health Choice <br /> Ambulance Services Clinical Coverage Policy No: 15 <br /> Effective Date:January 15,2020 <br /> 8.0 Policy Implementation and History <br /> Original Effective Date: February 1, 2016 <br /> History: <br /> Date Section or Change <br /> subsection Revised <br /> 02/01/2016 All sections and New policy documenting current coverage and services <br /> attachment(s) <br /> 03/15/2019 Table of Contents Added, "To all beneficiaries enrolled in a Prepaid <br /> Health Plan(PHP): for questions about benefits and <br /> services available on or after November 1,2019,please <br /> contact your PHP." <br /> 03/15/2019 All Sections and Updated policy template language. <br /> Attachments <br /> 08/15/2019 Section 3.2.1.5 Added Subsection"3.2.1.5 Transport to Behavioral <br /> Health Crisis Centers" <br /> NC Medicaid shall cover transport of Medicaid <br /> beneficiaries in behavioral health crisis to behavioral <br /> health clinics or alternative appropriate care locations <br /> when the following criteria are met: <br /> a. Emergency Medical Services (EMS)providers have <br /> received appropriate education in caring for <br /> beneficiaries in behavioral health crisis; <br /> b. EMS system has at least one partnership with a <br /> receiving facility that is able to provide care <br /> appropriate for those beneficiaries; and <br /> c. EMS systems shall be required to include in its <br /> EMS system plan a report on beneficiary <br /> experiences and outcomes in accordance with rules <br /> adopted by Department of Health and Human <br /> Services(DHHS),Division of Health Service <br /> Regulation(DHSR),Division of Health Benefits <br /> (DHB), and Office of Emergency Services(OEMS) <br /> Session Law 2018-5 11HA(a) <br /> 08/15/2019 Section 3.2.3.1 (g) Added: Emergency transport to a behavioral health <br /> clinic or other appropriate location during a behavioral <br /> health crisis. Effective Date: July 1, 2019 <br /> 01/15/2020 Table of Contents Updated policy template language, "To all beneficiaries <br /> enrolled in a Prepaid Health Plan(PHP): for questions <br /> about benefits and services available on or after <br /> implementation,please contact your PHP." <br /> 01/15/2020 Attachment A Added, "Unless directed otherwise, Institutional Claims <br /> must be billed according to the National Uniform <br /> Billing Guidelines. All claims must comply with <br /> National Coding Guidelines". <br /> 20A13 17 <br />