Pregnancy Medical Home Issue Resolved

The NCTracks system was updated on November 3 to allow the submission and payment of Pregnancy Medical Home claims. The system will support all three types of Pregnancy Medical Home claims that receive higher reimbursement, including the pregnancy risk screening, delivery, and post partum plan. All Pregnancy Medical Home claims billed after November 3rd will need to include the modifier “AF� with the procedure code submitted. The "AF" modifier will enable the provider to be paid at the rate previously received in the legacy system.

Providers who have previously filed Pregnancy Medical Home claims that were denied or pended for Edit 353 (rate not found) will need to re-submit claims. For claims previously paid at the lower rates, providers can submit claim adjustments.