Topics Related to All Providers

Budget proposals from the North Carolina General Assembly do not include funding for Healthy Opportunities Pilots services beyond June 30, 2025
Tobacco-related policy requirements will be effective starting on Jan. 1, 2027.
Care Management rate considerations effective July 1, 2025.
Reminder: NC Medicaid does not require Carolina Access/Advanced Medical Home referrals for specialty care.
Individual provider enrollment and Additional Managed Care Options
Effective April 1, 2025: NC Medicaid amended Clinical Coverage Policy 1G-2.
Policy is updated effective May 1, 2025
Effective May 1, 2025, NC Medicaid covers CPT 99483, Cognitive Assessment and Care Plan Service.
Effective May 1, 2025, NC Medicaid will provide coverage for CPT Code 0421U – ColoSense, a multi-target stool RNA-based colorectal cancer screening test.