Author: NC Medicaid Provider Reimbursement, (919) 527-7690
The Division of Health Benefits (NC Medicaid) has received approval from the Centers for Medicare & Medicaid Services (CMS) to increase rates for dental services.
Effective with dates of service Jan. 1, 2019, reimbursement rates for covered dental services were increased by 10 percent. Effective April 30, 2019, the revised rates have been implemented in the NCTracks system.
Based upon the original submission of the claim, claims that processed prior to the implementation of the rate increase will be automatically reprocessed through system adjustments to pay the additional reimbursement. Providers are reminded to bill their usual and customary charges rather than the Medicaid rate.
Providers will be notified through the general Medicaid Bulletin and/or NCTracks Provider Communications regarding the scheduled date for the system adjustments.
For current pricing on all dental codes, refer to the NC Medicaid website at https://medicaid.ncdhhs.gov/providers/fee-schedule/dental-fee-schedule.