Comparative Payment Rate Analysis

Beginning in 2026

The Centers for Medicare and Medicaid Services (CMS) now requires states to compare their rates for primary care, obstetrical and gynecological, and outpatient mental health and substance use disorder services to Medicare rates. CMS also established new requirements to publish the average hourly rate paid to direct care workers delivering personal care, home health aide, homemaker and habilitation services. States must publish these analyses every two years.

Reports are published in accordance with these requirements below:

• Calendar Year 2025 North Carolina HCBS Claims by Fee Schedule and Service Categories - published June 2026
• Calendar Year 2025 North Carolina Primary Care/Obestrical and Gynecological/Outpatient Behavioral Health Comparative Rate Analysis - published June 2026