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Providers

Update: Treatment Room Payment Policy

September 30, 2022

Dear Provider,

Thank you for your continued partnership with WellCare of North Carolina. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of new policies WellCare of North Carolina will be implementing effective December 1, 2022.

Policy Number

Policy Name

Policy Description

Lines of Business

CC.PP.071

Evaluation and Management Services Billed with Treatment Rooms

Disallows E&M services in treatment rooms as this does not represent a treatment type of service.

XL MD, XL MC

For detailed information about these policies, please refer to our website at www.wellcare.com. And for questions about this or any of our payment policies, please don't hesitate to reach out to our Provider Services team at 1-866-799-5318.

Sincerely,
WellCare of North Carolina

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Last Updated On: 9/30/2022
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