Assessment rates were affected by the implementation and subsequent reversal of the Oct. 1, 2025, per diem rate reductions.
Topics Related to Division of Health Benefits
Flexibilities effective Jan. 23, 2026, to Jan. 26, 2026, for NC Medicaid beneficiaries due to Winter Storm.
This bulletin corrects Current Procedure Terminology (CPT) code tables initially published Dec. 30, 2025.
Effective Jan. 1, 2026, NC Medicaid has amended Clinical Coverage Policy 1T-2.
Promulgation of New Clinical Coverage Policies and Amendment to Clinical Coverage Policy 8A Enhanced Mental Health and Substance Abuse Services.
Effective Jan. 1, 2026, The Acute Inpatient Hospital Services policy has been revised.
Effective with date of service Jan. 1, 2026, new Current Procedure Terminology (CPT) codes have been added or deleted, and descriptions of some existing codes have been updated.
Coverage for Healthcare Common Procedure Coding System Code G0512 is end-dating effective Dec. 31, 2025.
Effective for dates of service on or after Feb. 1, 2026, claims for certain drug testing procedure codes must include an individual ordering provider NPI.
Clinical Coverage Policy 1S-11 will include coverage for AlloMap® effective Jan. 1, 2026.