Blog Entry List
Effective July 3, 2025, claims submitted without the ordering or referring physician National Provider Identifier will be adjudicated with a pay status for the Community Alternatives Program for Children and Disabled Adults.
In recent months, NC Medicaid has published three survey reports that detail the experiences of beneficiaries and providers in North Carolina during 2024.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
Primary Care Provider (PCP) contracting deadline for Beneficiary Choice Period is Sept. 1, 2025.
Effective July 1, 2025, NC Medicaid will provide coverage for CPT Code 81515 – Xpert® Xpress MVP
Information on Provider Ombudsman, Children and Families Specialty Plan and Upcoming Credentialing Changes.
Standard Plans will reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
Reimbursement methodology changes revised to begin with dates of service on or after Dec. 1, 2024.
The North Carolina Department of Health and Human Services (NCDHHS), through General Dynamics Information Technology, Inc. (GDIT), will establish a Credentialing Committee to review files that contain flagged items for disposition of their enrollment, reenrollment and recredentialing applications and issues discovered through ongoing monitoring. This will apply to all providers enrolling with:
The Tailored Care Management payment rate is $294.86 effective July 1, 2025.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
The strategy outlines visions and goals for NC Medicaid Managed Care for the next three years.
NC Medicaid has released a new online tool for beneficiaries to compare the five available Standard Plans. The 2025 NC Medicaid Standard Plan Performance Comparison Tool is now available online.
NCDHHS is pleased to announce the release of the 2021-2023 NC Medicaid Annual Quality Report.