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Medicaid and Health Choice Providers

Service specific information for North Carolina Medicaid providers. Please select the program or service from the menu below and click GO.

SELECT PROGRAM OR SERVICE 1915(b)/(c) Medicaid Waiver for MH/DD/SAS Services Adult Care Home Ambulance Services Ambulatory Surgical Center Services Anesthesia Services Baby Love (Maternal Support Services) Behavioral Health Services ...CAP/MR-DD ...Critical Access Behavioral Health Agency ...Early Intervention Services (through CDSAs) ...Enhanced Behavioral Health Services (CIS) ...Inpatient Behavioral Health Services ...Outpatient Behavioral Health Services ...MH/DD/SAS Health Plan Waiver ...Psychiatric Residential Treatment Facility (PRTF) Services ...Residential Treatment Facility Services ...School-Based Psychological Services ...Targeted Case Management for Individuals with Intellectual and Developmental Disabilities Be Smart Medicaid Family Planning Waiver Case Management - Adults and Children At-Risk of Abuse, Neglect, or Exploitation Care Coordination for Children (CC4C) (formerly Child Service Coordination) Chiropractic Services Community Alternatives Program (CAP) ...CAP/C ...CAP/Choice ...CAP/DA ...CAP/MR-DD Dental and Orthodontic Services Durable Medical Equipment (DME) End-Stage Renal Disease Services Federally Qualified Health Centers (FQHC) Health Check Health Choice Health Departments Hearing Aids HIV Case Management Home Health Services Home Infusion Therapy (HIT) Hospice Services Hospital Services ICF/MR Independent Practitioner Services In-Home Care for Adults and Children(IHC) Laboratory Services Local Education Agencies (LEA) Local Management Entities (LME) Maternal Support Services Medicare Part D Money Follows the Person Nursing Facilities OB/GYN Services Optical Services and Visual Aids Orthotics and Prosthetics Outpatient Pharmacy Services Outpatient Specialized Therapies ...Early Intervention Services (through CDSAs) ...Health Departments ...Home Health Services ...Independent Practitioner Services ...Local Education Agencies (LEA) ...Outpatient Hospital Services ...Physician Services Personal Care Services (PCS) PCS-Plus Physicians Drug Program Physician Services ...Anesthesia Services ...OB/GYN Services ...Podiatry Services Pregnancy Medical Home Private Duty Nursing (PDN) Program Integrity Program of All Inclusive Care for the Elderly (PACE) Radiology Services Rules Actions Rural Health Clinics State Plan Transportation

What's New

• PCS Corrective Action Plan, revised-FINAL
• Roche Accu-Chek Diabetic Supplies Program Extension
• 1915i Personal Assistance Services (PAS)
• May 2012 Medicaid Bulletin
• 1915 b/c Medicaid Waiver Expansion Update
• April 2012 Basic Medicaid Billing Guide
• CMS Extension for PCS
• Rules Actions
• Sunset of ACH PCS and In-Home PCS

Hot Topics

• Final 5010 Dual Processing and Implementation Schedule
• 5010 Companion Guides and HIPAA Update
• CMS OESS Penalty Extension Letter for X12 ASC 5010
• Pharmacy Provider Generic Dispensing Rate Report
• Questions and Answers from the November 2011 Outpatient Seminars
• January 2012 National Drug Code Implementation Update Special Bulletin
• Medicaid Transportation
• Roche Extension Announcement
• Diabetic Supplies Recipient Notification
• NC Health Choice Claims Transition
• Notice of Rate Reductions
• Electronic Health Records Incentives: Information from CMS on provisions in the American Recovery and Reinvestment Act of 2009 to promote the use of electronic health records
• Medicaid Recipient Due Process Rights and Prior Approval Policies and Procedures
• Correct Coding - NCCI and Additional Edits
• N.C. Health Choice Clinical Coverage Policies
• Payment Error Rate Measurement (PERM)
• Prior Authorization Criteria for Medications Covered by Medicaid
• Provider Credentialing and Verification
• Remittance and Status Reports in PDF Format Request Form