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NC Division of Medical Assistance |
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DMA Clinical Policy and Programs
Phone Number 919-855-4380
Fax 919-715-2859
PDN is a medically necessary, substantial, complex, and continuous service that requires more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing staff of the hospital or skilled nursing facility and requires frequent skilled nursing interventions.
PDN services are provided under the direction of a written individualized plan of care signed by the recipient’s attending physician. Care is managed by a home care agency licensed by the Division of Facility Services enrolled with Medicaid as a PDN provider. Nursing services are rendered by a licensed registered nurse (RN) or licensed practical nurse (LPN) who is licensed by the North Carolina Board of Nursing and employed by the home care agency.
For service requirements, coverage criteria and limitations, refer to N.C. Medicaid Community Care Manual – Section 9, Private During Nursing
Additional information about Private Duty Nursing is available in the June 2004 Special Bulletin III, Private Duty Nursing Program Billing Guide
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.
