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Clinical Coverage Policies and Manuals
Proposed Medicaid Clinical Coverage Policies
Reporting a Change in Provider Status
How to start a facility from the NC Division of Health Service Regulation
DMA Clinical Policy and Programs
Phone Number (919) 855-4340
Fax (919) 733-2796
A nursing facility is an institution, or a distinct part of an institution, other than an intermediate care facility for the mentally retarded (ICF/MR), that is certified by Medicaid to provide nursing facility level of care services. Nursing facility care provides daily licensed nursing care but does not require the degree of medical consultation and support services available in an acute care hospital.
A nursing facility receiving Medicaid funding must be licensed by the NC Division of Health Service Regulation (DHSR) and comply with state and federal rules and regulations.
For service requirements, coverage criteria, and limitations refer to
For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.
To see forms that apply to all providers, please visit our Provider Forms page.
