Fee Schedules
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.
Program | Last Updated |
---|---|
Adult Day Care | See Personal Care Services |
(Applies only to Public Ambulance Providers under Managed Care) |
Oct. 22, 2021 |
Ambulance Services * | Dec. 17, 2021 |
Ambulatory Surgical Centers | Dec. 21, 2021 |
Anesthesiology Base Units | Jan. 22, 2022 |
Community Alternatives Programs | June 28, 2022 |
Chiropractic Services | Jan. 1, 2022 |
Clinical Pharmacist Practitioner | Feb. 11, 2022 |
Dental |
Ambulatory Surgery Center - Feb. 21, 2022 |
Dietary and Nutritional Services | Jan. 21, 2021 |
Dialysis Services | April 27, 2022 |
Durable Medical Equipment * | April 27, 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 | Feb. 17, 2022 |
HIV Case Management | March 29, 2022 |
Home Care | See Personal Care Services |
Home Health Services | March 30, 2022 |
Home Infusion Therapy | May 3, 2022 |
Hospice * | Dec. 21, 2021 |
Hospitals * | Varies by fee schedule type |
Hospital Outpatient Laboratory * (Applies only to Hospital Outpatient Laboratory Providers under Managed Care) |
Jan. 21, 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 | Jan. 21, 2022 |
Local Education Agencies | March 29, 2022 |
Local Health Departments (LHDs) | May 3, 2022 |
Nurse Midwives | May 5, 2022 |
Nurse Practitioner and CRNA * | April 25, 2022 |
Nursing Facility Rates * | March 31, 2022 |
Other Behavioral Health Services | Varies by type |
Optical Program | Jan. 1, 2022 |
Optometry Services | Jan. 1, 2022 |
Orthotics and Prosthetics | Feb. 7, 2022 |
Outpatient Specialized Therapies | Varies by practitioner type |
Personal Care Services | June 28, 2022 |
Pharmacy * | Varies by type |
Physician Assistant * | April 25, 2022 |
Physician Administered Drug Program | June 6, 2022 |
Physician Services * | May 3, 2022 |
Podiatry Services | Jan. 1, 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 | Dec. 20, 2021 |
This page was last modified on 06/28/2022
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