Behavioral Health, Mental Health, IDD

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: Yes. CQL is being added as an accepted accrediting body for all Services requiring national accreditation under 251S00000X. Providers with CQL accreditation should wait until the PPM is updated before submitting an MCR to upload their accreditation. An NCTracks Announcement will be published and the PPM updated once the addition is complete. 

A: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers (OPT) is being added as a Service under the organizational taxonomy 251S00000X. 

Upon implementation of the change, this Service will require the affiliation of at least one behavioral health provider and 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 and fingerprinting of individual owners. Please monitor the NCTracks website for information about these new Services expected in early August.

A: Yes. The following Innovations Waiver Services that do not require national requirement will be added to the PPM and NCTracks under 251S00000X: Assistive Technology - Equipment and Supplies, Financial Support Services, Home Delivered Meals, Home Modifications, Specialized Consultation Services, Vehicle Modifications. 

Upon implementation of the change, this Service will require the affiliation of at least one behavioral health provider and 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 and fingerprinting of individual owners. Please monitor the NCTracks website for information about these new Services expected in early August.

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

A: No, 251S00000X is an organizational only taxonomy. This requirement under 251S00000X does not apply to individual providers. Please see the PPM for Services that require national accreditation and their approved accrediting body. 

A: Specialized Consultative Services currently listed on the Provider Permission Matrix (PPM) will be removed. Specialized Consultation Services in the Innovations waiver will be added to the PPM and will 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: Providers should select the taxonomy that most closely aligns to the services rendered. Additional Services are being added to the PPM in NCTracks through August 2026. An NCTracks Announcement will be published and the PPM updated as updates are made. 

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: 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.