This bulletin corrects Current Procedure Terminology (CPT) code tables initially published Dec. 30, 2025.
Topics Related to Behavioral Health Providers
Promulgation of New Clinical Coverage Policies and Amendment to Clinical Coverage Policy 8A Enhanced Mental Health and Substance Abuse Services.
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.
This announcement is for NC Medicaid and Division of Mental Health, Developmental Disabilities, and Substance Use Services State Funded Behavioral Health Providers.
Recent court rulings now require the North Carolina Department of Health and Human Services to reverse provider rate reductions and restore rates to their Sept. 30, 2025, levels.
A psychiatric diagnostic interview (Current Procedural Terminology 90792) may qualify as a Comprehensive Clinical Assessment if it meets all requirements.
The revised NC Medicaid 1915(i) Assessment includes new date fields and must be used starting Oct. 1, 2025.
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.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.