by AlexF | Feb 11, 2026 | Billing, Insurance
Find answers to the most common questions about SHP below, provided by Liz Nieland. Check back often — this page will be updated with new information as it becomes available. Q: I have called a SHP patient’s insurance to verify that S8990 was not a...
by NCCA | Jan 6, 2026 | Billing
Official confirmation regarding the Aetna State Health Plan (SHP) fee schedule changes effective January 1, 2026. According to Aetna’s provider information, the Clear Pricing Project (CPP)—the unique Aetna SHP fee schedule—is ending on December 31, 2025. Effective...
by NCCA | Jul 30, 2025 | Billing, Insurance
Courtesy of Medicaid NCDHHS | As of July 18, 2025 New diagnosis codes now accepted for chiropractic services effective Aug. 1, 2024. NC Medicaid identified a system issue that resulted in denials of chiropractic service claims when providers submitted valid diagnosis...
by NCCA | Feb 27, 2025 | Billing
Courtesy of Physician Practices Specialists Listed below are some essential questions you must answer before deciding to use a q6 or q5 modifier. The first question is what’s asked most often. Can I use a locums modifier during the credentialing process? Using a...
by NCCA | Feb 26, 2025 | Billing, Insurance
The NCCA has received numerous questions and concerns regarding the Aetna SHP fee schedule for S8990. The NCCA verified with the SHP that it is a covered code. Many have asked why the fee schedule is different and how Aetna can not follow the 50% of eligible billed...
by NCCA | Jan 9, 2025 | Billing, Insurance, Member News
BCBSNC On July 29, 2024, Health Network Solutions notified providers via email that BCBSNC plans to require prior authorization for most physical therapy codes for its fully insured plans starting October 1, 2024. Since then, the effective date was moved to...
