NC Medicaid, in collaboration with the four NC Medicaid Managed Care Standard Plans, will host the Sixth Annual Virtual Statewide Quality Forum on Wednesday, Oct. 14, 2026, from 11 a.m. to 1 p.m.
Topics Related to All Providers
Amendments to Clinical Coverage Policy 1A-20, expanding medical necessity criteria and updating coverage for sleep studies and polysomnography services are effective July 1, 2026.
Adverse determination letters generated through NCTracks have been updated to reflect these changes.
Effective July 1, 2026, NC Medicaid has amended Clinical Coverage Policy 10A, Outpatient Specialized Therapy Services.
Local Health Departments will continue to offer Care Management for At Risk Children and Care Management for High-Risk Pregnancy services to Medicaid beneficiaries, with Per Member Per Month payments remaining in effect, both through Dec. 31, 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.
Modifier CR should only be appended to procedure codes when services are directly related to a Federal or State-declared emergency or disaster.