Topics Related to Division of Health Benefits

Prime Therapeutics is the New Pharmacy Benefit Administrator for NC Medicaid Direct Point of Sale Pharmacy, effective May 2, 2026.
These revisions are a result of the Current Dental Terminology CDT-2026 American Dental Association (ADA) code updates.
These revisions are a result of the Current Dental Terminology CDT-2026 American Dental Association (ADA) code updates.
Information about a new Provider Directory API, recent provider communications, upcoming webinars and more.
Action Required: Providers with Active 251S00000X Taxonomy must select Service and meet national accreditation requirements within one year.
Action Required: Providers with Active 251S00000X Taxonomy must select New Service and Report National Accreditation.
Modifier CR should only be appended to procedure codes when services are directly related to a Federal or State-declared emergency or disaster.
The Centers for Medicare & Medicaid Services has released 80 new ICD-10-PCS codes, Effective April 1, 2026.
This bulletin updates the previously published NC Medicaid Direct Pharmacy Benefits Administrator Provider Transition Overview and Webinars bulletin.
NC Medicaid providers must accurately answer all Exclusion Sanction questions.