NC Medicaid is implementing changes pursuant to a Medicaid State Plan Amendment to revise the PADP fee schedule. These changes are pending approval from the Centers for Medicare & Medicaid Services (CMS) with an effective date of Feb. 1, 2024. This bulletin applies to both NC Medicaid Direct and NC Medicaid Managed Care.
NC Medicaid will update the PADP fee schedule quarterly to reflect current acquisition costs. Rates will be aligned with the quarterly release of the CMS update of prices. Additionally, the Local Health Department, Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Ambulatory Infusion Therapy Centers will see future updates to reimbursement rates of Physician Administered Drugs on their fee schedules.
For more information on the PADP, please see the NC Medicaid Physician Administered Drug Program webpage.
Contact
NCTracks Call Center: 800-688-6696