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NC Medicaid »   Providers »   Fee Schedules

Fee Schedules

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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

Ambulance Provider *

(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
Federally Qualified Health Center - Feb. 18, 2022
General - Feb. 17, 2022
Rural Health Center - Feb. 18, 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

Pregnancy Medical Home

(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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NC Medicaid
Division of Health Benefits

2501 Mail Service Center
Raleigh, NC 27699-2501
 
NC Medicaid Contact Center
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Closed on State holidays. 
 
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https://medicaid.ncdhhs.gov/providers/fee-schedules