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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