Medicaid Bulletin

Articles published prior to January 2018 are available in the Medicaid Bulletin Archive.

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Transition of Pharmacy Benefit Administrator for NC Medicaid Direct

NOTE: This change applies only to NC Medicaid Direct beneficiaries. There is no impact to beneficiaries enrolled in NC Medicaid Managed Care.

Updates to NC Medicaid Temporary Flexibilities Due to Additional Winter Storm
Flexibilities extended through Feb. 6, 2026, for NC Medicaid beneficiaries due to additional Winter Storm weather.
Quarterly Provider Update – Winter 2026
Information on Required Provider Disclosures, Children and Families Specialty Plan Flexibilities, Case Manager/Care Coordinators Updates and more.
Extended NC Medicaid Temporary Flexibility Due to January Winter Storm
Flexibility extended to Jan. 30, 2026, for NC Medicaid beneficiaries due to Winter Storm.
Skilled Nursing Facility Provider Assessment Updates
Assessment rates were affected by the implementation and subsequent reversal of the Oct. 1, 2025, per diem rate reductions.
NC Medicaid Temporary Flexibilities Due to Expected January Winter Storm
Flexibilities effective Jan. 23, 2026, to Jan. 26, 2026, for NC Medicaid beneficiaries due to Winter Storm.
Current Procedure Terminology Code Update 2026 Correction
This bulletin corrects Current Procedure Terminology (CPT) code tables initially published Dec. 30, 2025.
Clinical Coverage Policy Update 1T-2, Special Ophthalmological Services
Effective Jan. 1, 2026, NC Medicaid has amended Clinical Coverage Policy 1T-2.
Behavioral Health Clinical Coverage Policy Updates
Promulgation of New Clinical Coverage Policies and Amendment to Clinical Coverage Policy 8A Enhanced Mental Health and Substance Abuse Services.
2A-1 Acute Inpatient Hospital Services Policy Update
Effective Jan. 1, 2026, The Acute Inpatient Hospital Services policy has been revised.