OB/GYN Services

OB/GYN services include medically necessary obstetrical and gynecological care, and family planning.

Fee Schedules

OB/GYN Clinical Coverage Policies

  • 1E-1, Hysterectomy
  • 1E-2, Therapeutic and Non-therapeutic Abortions
  • 1E-3, Sterilization Procedures
  • 1E-4, Fetal Surveillance
  • 1E-5, Obstetrics

Radiology Clinical Coverage Policies

  •  1K-7, Prior Approval for Imaging Services

Clinical Coverage Policy 1K-7, Prior Approval for Imaging Procedures


NC Medicaid Clinical Section
Phone: 919-855-4320
Fax: 919-733-2796