Includes medical and pharmacy prior authorizations, out-of-network provider rates and rules and primary care provider changes.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
The fact sheet outlines the key responsibilities of practices receiving auto-assigned members.
Effective Oct. 1, 2025, NC Medicaid will no longer cover the prescription drug Xifaxan (Rifaximin).
Providers can no longer bill NC Medicaid for Hospital at Home for dates of service on or after Oct. 1, 2025.
Flexibilities effective Sept. 26, 2025, for NC Medicaid beneficiaries due to Hurricane Humberto and Tropical Storm Invest 94L (Potential Imelda).
Fee schedules impacted by rate reductions will be released Oct. 1 2025, but are subject to change if additional appropriations are made available.
Current Procedural Terminology (CPT) code 99177, Screening of Eye with Special Instrument Onsite Analysis is separately reimbursable effective Nov. 1, 2024.
NC Medicaid is providing additional information to providers about new federal prohibitions on certain providers.
Providers and pharmacies should always use NCTracks to confirm Medicaid eligibility
Effective Sept. 16, 2025, the Total Cost of Care Dashboard is decommissioned.