Private Duty Nursing (PDN)

Private Duty Nursing (PDN) is substantial, complex, and continuous skilled nursing care provided in the home for medically fragile Medicaid beneficiaries. This service is considered supplemental to the care provided by a beneficiary’s family or designated caregivers, and allows the beneficiary to remain in their residence rather than an institution. Prior approval (PA) is required for PDN services, and is granted based on the beneficiary’s medical necessity and fragility.

Eligible Direct Care Workers One-Time Bonus and Wage Increase

The Current Operations Appropriations Act of 2021 approved a Medicaid budget provision to give a one-time bonus to eligible direct care workers (DCWs) and support staff who provide services to Medicaid and NC Health Choice beneficiaries. The State budget also includes a provision to implement a home- and community-based services (HCBS) and intermediate care facility/individuals with intellectual disabilities (ICF-IID) DCW wage increase for eligible employees who provide services to Medicaid and NC Health Choice beneficiaries.

Details about the three categories of eligibility criteria can be found in the following NC Medicaid provider bulletins, posted Jan. 14, 2022: 

  • COVID-19 BULLETIN #212  One-Time Bonus: DCWs and support staff in waiver programs, personal care services, home health and others may be eligible for a one-time bonus.
  • COVID-19 BULLETIN #213  ICF-IID Wage Increase: DCWs in Intermediate Care Facilities for Individuals with Intellectual Disabilities may be eligible for a wage increase.
  • COVID-19 BULLETIN #214  HCBS Wage Increase: DCWs providing home- and community-based service may be eligible for a wage increase.

NC Medicaid will hold webinars from Jan. 19-25, 2022, to provide an overview of the wage increase and bonus program. Webinar information is located in the provider bulletins listed above. 


As valued partners of NC Medicaid, we are requesting your participation in a summer engagement session for Private Duty Nursing (PDN) stakeholders. The purpose of this session is to share, and discuss updates previously submitted, as well as share additional Long -Term Services & Supports updates.
Please share this invitation with your beneficiaries and their caregivers.

Date: Feb. 23, 2022

Date: Sept. 16, 2021

Date: Dec. 17, 2020


Policies and FAQ



NC Medicaid Clinical Section
Phone: 919-855-4380



Tab/Accordion Items


March 2020 PDN Stakeholder Meeting Postponed

In response to the COVID-19 pandemic, NCDHHS is taking necessary precautions to protect the public. As a result, Medicaid is taking the necessary precautions and implementing cancellation of in-person meetings during this time. The March 27, 2020 PDN Stakeholder meeting is postponed until further notice. Updates and additional information will be provided in an email sent to the stakeholder group in the coming weeks. 

Stakeholders may submit questions via email to