Fee Schedules Archive
Effective Nov. 3, 2022, all updates to the NC Medicaid Fee Schedules are located in the Fee Schedule and Covered Code site. Please review the User Guide for additional information on navigating the new site.
Fee schedules prior to Nov. 3, including archives, are available at the links below.
A C D E F G H I L N O P R T U-Z
Fee schedules with an asterisk (*) denote rate floors. Rate floors are the established NC Medicaid Direct (fee-for-service) rate that PHPs are required to reimburse Medicaid providers (no less than 100% of the applicable NC Medicaid Direct rate), unless the PHP and provider mutually agree to an alternative reimbursement arrangement. The alternative reimbursement arrangement exception does not apply to durable medical equipment (DME) providers or physicians administered drug program (PADP) services.
| Program | Last Updated |
|---|---|
| Adult Day Care | See Personal Care Services |
|
(Applies only to Public Ambulance Providers under Managed Care) |
Oct. 19, 2022 |
| Ambulance Services * | Dec. 17, 2021 |
| Ambulatory Surgical Centers | Aug. 24, 2022 |
| Anesthesiology Base Units | Jan. 22, 2022 |
| Chiropractic Services | Jan. 1, 2022 |
| Clinical Pharmacist Practitioner | Feb. 11, 2022 |
| Community Alternatives Programs | July 15, 2022 |
| COVID-19 VAC & MAB Administration Fee Schedule for Outpatient | Oct. 5, 2022 |
| Dental |
Ambulatory Surgery Center - Feb. 21, 2022 |
| Dietary and Nutritional Services | Jan. 21, 2021 |
| Dialysis Services | April 27, 2022 |
| Durable Medical Equipment * | Aug. 22, 2022 |
| Enhanced Mental Health Services | April 27, 2022 |
| Federally Qualified Health Centers * | Varies by fee schedule type |
| Freestanding Birth Center | Dec. 21, 2021 |
| Geropsychiatric | July 1, 2012 |
| Hearing Aid Program | Sept. 7, 2022 |
| HIV Case Management | March 29, 2022 |
| Home Care | See Personal Care Services |
| Home Health Services | March 30, 2022 |
| Home Infusion Therapy | Sept. 19, 2022 |
| Hospice * | Oct. 1, 2022 |
| Hospitals * | Varies by fee schedule type |
|
Hospital Outpatient Laboratory * (Applies only to Hospital Outpatient Laboratory Providers under Managed Care) |
Sept. 19, 2022 |
| Indian Tribal (I/T/U) Home Health * | Dec. 30, 2021 |
| Indian Tribal (I/T/U) Pharmacy | May 24, 2022 |
| Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) | Feb. 3, 2022 |
| Laboratory | Sept. 19, 2022 |
| Local Education Agencies | Sept. 8, 2022 |
| Local Health Departments (LHDs) | Sept. 20, 2022 |
| Nurse Midwives | Oct. 12, 2022 |
| Nurse Practitioner and CRNA * | Aug. 16, 2022 |
| Nursing Facility Rates * | Oct. 6, 2022 |
| Other Behavioral Health Services | Varies by type |
| Optical Program | Jan. 1, 2022 |
| Optometry Services | Sept. 12, 2022 |
| Orthotics and Prosthetics | Feb. 7, 2022 |
| Outpatient Specialized Therapies | Varies by practitioner type |
| Personal Care Services | Sept. 8, 2022 |
| Pharmacy * | Varies by type |
| Physician Assistant * | Aug. 10, 2022 |
| Physician Administered Drug Program | Oct. 19, 2022 |
| Physician Services * | Oct. 11, 2022 |
| Podiatry Services | Sept. 6, 2022 |
|
(Replaced by Pregnancy Management Program) |
July 13, 2021 |
| Private Duty Nursing | Feb. 28, 2022 |
| Psychiatric Reduction Percentage Payment Schedule | March 1, 2009 |
| Radiological/Imaging Services | Varies by practitioner type |
| Rural Health Clinic * | Varies by fee schedule type |
| Targeted Case Management | Feb. 9, 2021 |
| Vent Facility Rates | July 1, 2022 |
This page was last modified on 01/24/2023