North Carolina Medicaid: Don't delay well-child visits

Immediately: Billing team must update scheduling and billing workflows to reflect that 2-year well-child visits (CPT 99382, 99392) can be scheduled and billed BEFORE the child's second birthday for UnitedHealthcare Community Plan of North Carolina members. Update encounter forms and billing system validation rules to remove any restrictions preventing pre-birthday scheduling. Provide guidance to front desk/scheduling staff that these visits are fully reimbursable prior to the birthday. Additionally, update billing software and staff training to clarify that well-child visits for ages 3–21 (CPT 99383, 99384, 99385, 99393, 99394, 99395) no longer require 365-day spacing and are covered per calendar year. Use modifier EP when applicable for EPSDT-eligible ages 0–20. Ensure clinical staff understand the immunization compliance deadline (vaccines must be completed by second birthday to count toward CIS Combo 10 measures) to support early scheduling.