Behavioral Health

A: Providers should select the taxonomy that most closely aligns to the services rendered. Additional Services were added to the PPM in August 2026. Please review the NCTracks Announcements and the most recent PPM for additional information. 

Please review the PPM at that time to determine if one of those Services is appropriate for enrollment. Additional questions can be directed to the Provider Ombudsman at Medicaid.ProviderOmbudsman@dhhs.nc.gov.

A: Per 108C-3(g)(2), taxonomy 251S00000X is designated as High Categorical Risk, requiring a site visit and fingerprinting unless an associated national accreditation is active for the same location and service. 

Enrolling with taxonomy 251S00000X requires at least one Service Type and Service on the provider record.

• Providers had a deadline of Oct. 1, 2026, to complete this update to their record
• On Nov. 2, 2026, the 251S00000X taxonomy will terminate for organization records that do not have an active Service or a submitted and pending MCR or reverification application to add a Service. 

Accepted Service Types and Services available under this taxonomy are listed on the Provider Permission Matrix (PPM).

A: NC Medicaid updated criteria for certain Community Intervention Services (CIS) and Innovations Waiver (IW) Services under the 251S00000X (Community/Behavioral Health Agency) taxonomy to  require national accreditation. Information about services requiring national accreditation and their approved accrediting bodies is available on the Provider Permission Matrix (PPM).

A: CQL is available  as an accepted accrediting body for all Services added to the PPM under taxonomy 251S00000X in 2026 that require national accreditation. The PPM is updated and providers can submit an MCR to upload their accreditation. 

Additional information is available in the Updates to NC Innovations Waiver Services for Taxonomy 251S00000X.

A: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers (OPT) is available as a Service  for behavioral health provider billing under the NC Medicaid Clinical Coverage Policy (CCP) 8C-Outpatient Behavioral Health Services Provided by Direct Enrolled Providers and other Services offered under the organizational taxonomy 251S00000X.  If an organization provider renders additional Behavioral Health services, enrollment under taxonomy code 251S00000X is required.

For organization providers who render additional services, this gives the opportunity for those providers to indicate all services under the same taxonomy without having to add a second taxonomy. This enrollment also allows the organization to add Outpatient Therapy as a service in addition to the non-endorsed Behavioral Health services.

Selection of the OPT Services under taxonomy 251S00000X also requires the affiliation of at least one behavioral health provider and has a High categorical risk level as required by NC Gen. Stat. 108C-3(g)(2) instead of national accreditation. A High categorial risk level requires a site visit, as well as fingerprinting of individual owners. Additional information is available in the Community Intervention Services Enrollment Updates communication.

A: Organizational providers that exclusively provide Outpatient Behavioral Health Services Provider by Direct-Enrolled Providers (OPT) as defined in Clinical Coverage Policy (CCP) 8C are not required to enroll under taxonomy code 251S00000X, provided OPT is the only service being rendered.

However, if an organization provider renders additional non-endorsed Behavioral Health services, enrollment under taxonomy code 251S00000X is required. This enrollment also allows the organization to add Outpatient Therapy as a service in addition to the non-endorsed Behavioral Health services.

Organizations that provide only OPT services may elect to enroll under taxonomy code 193200000X (Multi-Specialty) or 193400000X (Single-Specialty), following a review of the applicable enrollment requirements outlined in the NC Medicaid Provider Permission Matrix (PPM).

Providers should review the applicable PPM requirements to ensure the selected taxonomy aligns with their services and enrollment eligibility.

A: The following Innovations Waiver Services that do not require national requirement are available on the PPM and NCTracks under the 251S00000X and additional taxonomies: Assistive Technology - Equipment and Supplies, Financial Support Services, Home Delivered Meals, Home Modifications, Specialized Consultation Services, Vehicle Modifications. Please see the Innovations Waiver Program and Community Intervention Service Enrollment Updates announcement for more information.

 The taxonomy will carry a High categorical risk level as required by NC Gen. Stat. 108C-3(g)(2) instead of national accreditation. A High categorial risk level requires a site visit as well as  fingerprinting of individual owners.

A: Sign up for NCTracks announcements on the right-hand side of the NCTracks Provider Communication page. 

A: No, 251S00000X is only selectable by organizations. Please see the PPM for Services that require national accreditation and their approved accrediting body. 

A: Specialized Consultative Services is a CIS Service listed on the Provider Permission Matrix (PPM).

Specialized Consultation Services is an Innovations Waiver Program Service that has been recently added to the PPM and does NOT require national accreditation or mental health license. 

A: Providers should thoroughly review the NC Medicaid Clinical Coverage Policies to confirm the service rendered, and then review the PPM to determine the criteria required for enrollment into that Service. Additional Services are anticipated to be added to the PPM soon.

A: Accreditation timelines depend on the service type:

• Innovations Waiver Services (IWS): Accreditation is required before enrollment. 
• Community Intervention Services (CIS): Accreditation must be obtained within the timeframe listed in the Provider Permission Matrix (PPM), which may be either 1 year or 3 years. 

Note: Providers enrolled with a CIS service under the 251S00000X taxonomy before April 19, 2026, will have until April 19, 2027 to upload proof of national accreditation. Providers newly enrolling with a Service under the 251S00000X taxonomy that requires national accreditation will have the time indicated on the PPM. If an IWS, national accreditation will be required at the time of selection. If a CIS, national accreditation will be required within 1-3 years depending on the Service selected.

A:  NC Medicaid and NCTracks will review an official extension letter from an accrediting body to determine if acceptable as temporary proof of continued accreditation status.

Providers should:

• Submit a Manage Change Request (MCR) and report the change with the accreditation.
• Upload the extension letter in NCTracks as part of the MCR or accreditation update.
• Use the extension letter as verification of continued accreditation if requested by the health plans as they may verify accreditation status for currently enrolled  providers through April 19, 2027.

A: Providers can utilize the following resources:

• NCTracks User Guides & Fact Sheets job aids for provider enrollment and accreditation 
• NCTracks Call Center: 800-688-6696
• Sign up for NCTracks Announcements to be informed of updates and training opportunities.
• NC Medicaid Provider Ombudsman inquiries, concerns or complaints can be submitted to Medicaid.ProviderOmbudsman@dhhs.nc.gov or the Provider Ombudsman line at 866-304-7062.