NC Integrated Care for Kids Closeout and Related Billing Code Changes

History of NC Integrated Care for Kids Billing Codes

NC InCK was a seven-year pilot program that aimed to improve the way children under age 21 and their families received care and support services. One element of the program was an Alternative Payment Model (APM) used to incentivize specific quality improvement and operational excellence.

Beginning in September 2022, NC Medicaid implemented a set of new billable codes to capture primary care provider activities to address social drivers of health for Medicaid beneficiaries. These codes were set up to capture data only and were reimbursed at $0. While the codes were open for use by all providers to bill to both NC Medicaid Direct and Standard Plans, they were primarily intended to measure performance of providers participating in the InCK APM.

Codes Used to Track Food and Housing Screening

Healthcare Common Procedure Coding System (HCPCS) and ICD-10 codes were introduced to capture information on whether a provider conducted a food or housing screening and data on the outcome of the screening. The following non-reimbursable G codes are currently used to document a food- or housing-related screening for InCK:

G9919: Screening Performance and Positive and Provision of Services

G9920: Screening Performed and Negative

G9921: Positive Screening Without Recommendations (This code was end dated by HCPCS on Dec. 31, 2024, and has already been removed from the NC Medicaid system)

Although these G codes will no longer be available for use, NC Medicaid continues to prioritize the screening of Members for social needs and tracks these screenings using other data sources. Any claims that contain codes G9919 and G9920 after Dec. 31, 2026, will be rejected.

Code Used to Track the Primary Care Kindergarten Readiness Promotion Bundle

The Kindergarten Readiness Promotion Bundle (KRPB) is a set of interventions that primary care practices can provide or connect children and families to within the community. Activities in the bundle can be delivered at well-child visits from birth to age 6. More information on the KRPB is available in the Kindergarten Readiness Health Care Provider Guide presentation.

This code can be used by any provider that delivers services included in the bundle during a well-child visit, even if the provider does not participate in the NC InCK program. Although this code was originally intended to capture NC InCK APM performance, the KRPB-related code should continue to be used after the pilot’s end in December 2026. NC Medicaid remains interested in tracking the provision of well-child visits that include community referrals or other methods of addressing Health Related Social Needs. Data from the use of the KRPB code may also guide the development and direction of future pediatric-focused NC Medicaid programs.

Billing Current Procedural Terminology (CPT) code 1003F was used to indicate that a provider completed at least five of the actions included in the KRPB and should be added to the usual CPT and diagnosis code for well visits. No reimbursement is provided for CPT code 1003F.

The following interventions all count toward the five required activities needed to use the 1003F KRPB code:

• Conduct well visit
• Hearing and vision screening
• Developmental screening
• Social-emotional screening
• Office-based literacy promotion
• Fluoride varnish
• Referral to Pre-K
• Referral to Exceptional Children’s program
• Provide/referral to parenting support program
• Referral to Children’s Developmental Services Agency (CDSA)
• Provide/referral to an early childhood mental health program
• Referral to a community-based literacy program

Providers should use the following billing guidance to document the receipt of the KRPB:

For more information on the Integrated Care for Kids program, please see the NC Medicaid InCK webpage.

Contact 

NC Medicaid Contact Center
888-245-0179