Current Procedure Terminology Code Update 2026 Correction

This bulletin is related to NC Medicaid Direct.

NC Medicaid has been notified that there was an error in the 2026 Current Procedure Terminology Code Update bulletin published Dec. 30, 2025. The bulletin erroneously listed new HCPCS codes as being end-dated Dec. 31, 2025. Corrected tables are as follows:

Note: NC Medicaid did not elect to cover any new Healthcare Common Procedure Coding System (HCPCS) codes for 2026, except those related to pharmacy services. The Pharmacy Section will notify providers when new drug codes are added to NCTracks.

Note: All Category II and III Codes are not covered.

A bulletin article will be released listing the new codes that will be separately reimbursable by Ambulatory Surgery Centers (ASC) when that information is released by the Centers for Medicare & Medicaid Services (CMS) in January 2026.

The pharmacy section will notify providers when new drug codes are added to NC Tracks.

The State and GDIT are in the process of completing system updates to align our policies with CPT code changes (new codes, covered and non-covered, as well as the end-dated codes), to ensure that claims billed with the new codes will process and pay correctly.

Until this process is completed, claims submitted with new covered codes will pend for “no fee on file.” These pended claims will recycle and pay when the system work is completed. No additional action will be required by providers to ensure that claims process and pay correctly after the system work is completed. This process will also be applicable to the Medicare crossover claims.

To maintain cash flow, when appropriate, providers may wish to split claims and bill new codes on a separate claim. This will ensure that only claims billed with the new procedure codes are pended for processing.

Contact

NC Tracks Contact Center
800-688-6696