Fact Sheets | NC Medicaid

Managed Care Claims Submission: What Providers Need to Know – Part 1

What Providers Need to Know Before Children and Families Specialty Plan Launch, Part 1

What Providers Need to Know After Children and Families Specialty Plan Launch, Part 2

Provider Quick Reference Guide for the Children and Families Specialty Plan

Children and Family Specialty Plan (CFSP) Managed Care Claims and Prior Authorizations Submission: Frequently Asked Questions – Part 2

Primary Care Provider Enrollee Report Guide for the Children and Families Specialty Plan

Tailored Plan - Provider Quick Reference Guide

Standard Plan - Provider Quick Reference Guide

Eastern Band of Cherokee Indians Tribal Option Overview

Understanding the Mandatory Closed Networks Requirement

Department Fact Sheets

Enrollment Broker Information

NC Medicaid Provider and Health Plan Lookup Tool - Feb. 28, 2024
For more information on the NC Medicaid Enrollment Broker notices and beneficiary materials, visit the Beneficiary Materials page.

Non-Emergency Medical Transportation (NEMT)

For facts sheets regarding Non-Emergency Medical Transportation (NEMT), please see the NEMT page on the County Playbook

NC Medicaid Programs and Services

Medicaid Services for Justice-Involved Youth Per Section 5121 of the 2023 Consolidated Appropriations Act - March 24, 2025
Processes and Frequently Asked Questions for 1915(i) Services - Jan. 13, 2025
Tailored Care Management NC Medicaid Direct / Managed Care Enrollee Report - July 25, 2024
Tailored Plan Managed Care Claims and Prior Authorizations Submission:
Frequently Asked Questions – Part 2 - May 30, 2024
LME/MCO Consolidation Overview and FAQs – For Providers - January 2024
What Providers need to know about Medicaid Expansion - Sept. 19, 2023
NCCARE360-Healthy Opportunities (HOP) talking points - Sept. 5, 2023
Enrollee Report Updates for Primary Care Practices in Advance of Tailored Plan Launch - June 24, 2024
Home and Community Based Service Monitoring Tool Training - June 16, 2023
Managed Care Claims Submission: What Providers Need to Know – Part 1 - June 27, 2024
Provider Payment and Reimbursement - Nov. 18, 2025
NC Health Choice Move to Medicaid - Feb. 28, 2024
NC Health Choice Move to Medicaid Questions and Answers Fact Sheet - March 21, 2023
NC Medicaid Managed Care: Provider Training - Feb. 28, 2024
Advanced Medical Home - Nov. 14, 2022
Transition of Care - March 15, 2024
Nursing Facility - Health Plan Process - Oct. 17, 2022
Nursing Facility Placement - Oct. 17, 2022
Provider Postpartum - March 21, 2022
What Providers Need to Know About Pharmacy - March 15, 2024
Managed Care Claims and Prior Authorization Submission: Frequently Asked Questions - Part 2 - May 14, 2024
Panel Management - July 30, 2024
Prompt Payment - Dec. 18, 2024
Managed Care PCP/AMH Provider Payment Matrix - June 14, 2021
Health Equity Enhanced Payment Initiative - March 31, 2021
Overview of Provider Directory Data Flow - Sept. 27, 2022
Managed Care Eligibility for Newborns: What Providers Need to Know - Jan. 9, 2023
Protections for Pregnant Women and Newborns - Dec. 19, 2022
Telehealth Program - March 14, 2025
Transitioning 1915(b)(3) Services to 1915(i) Authority: Service Providers - April 2023
Transitioning1915(b)(3) Services to 1915(i) Authority: Tailored Care Management Providers - April 2023
1915(i) Tailored Care Manager Assessment Training - May 2023
North Carolina’s Transition of 1915(b)(3) Benefits to 1915(i) - March 15, 2024

Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Fact Sheet

Credentialing Committee - March 25, 2025

Visit the Provider Data Management and Credentialing Verification Organization page for information on a new solution to align North Carolina’s credentialing process with the National Committee for Quality Assurance Standards.

AHEC Guides

AHEC Practice Support

For more information on AHEC practice support including the Back Porch Series, visit the AHEC Practice Support page.

Health Plan Resources

Additional Resources

For additional health plan resources and contact information, visit the Health Plan Contacts and Resources page.
For additional health plan training opportunities, visit the Provider Playbook: Training Courses page.