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  • Fee Schedules - NC Medicaid
    Ambulance Provider Fee Schedule - Oct 19, 2022 - EXCEL: Ambulance Provider Fee Schedule - Oct 19, 2022 -PDF: NC Medicaid Contact Center Phone: 888-245-0179 Monday-Friday 8 a m to 5 p m Closed on State holidays Visit RelayNC for information about TTY services More Follow Us
  • New Medicaid Bulletin Articles as of Feb. 21
    Point-of-Sale COVID and Flu Vaccine Reimbursement Updates 2025 - The PREP Act is extended to Dec 31, 2029, expanding COVID-19 and flu vaccine access at pharmacy Point-of-Sale for ages 3 and older Revisions to Inclusion of Drug Code Rates on Fee Schedules - Effective Feb 3, 2025, unless communicated otherwise by the Department
  • Billing Codes Rates | Check Write Schedule - Trillium Health Resources
    Trillium has released an updated fee schedule containing the Innovations DCW increases retroactive to July 1, 2023 Providers can begin using the updated rates on or after December 20, 2023
  • Fee Schedules Archive - NC Medicaid
    Effective Nov 3, 2022, all updates to the NC Medicaid Fee Schedules are located in the Fee Schedule and Covered Code site Please review the User Guide for additional information on navigating the new site Fee schedules prior to Nov 3, including archives, are available at the links below
  • 2025 CPT Code Update - NC Medicaid
    New CPT codes that are covered by NC Medicaid Direct are effective with date of service Jan 1, 2025 Claims submitted with end-dated codes will be denied for dates of service on or after Jan 1, 2025 Previous policy restrictions continue in effect unless otherwise noted
  • Revisions to Inclusion of Drug Code Rates on Fee Schedules
    Effective Feb 3, 2025, unless communicated otherwise by the Department, drug codes and rates previously listed on the Medicaid fee schedules listed below will be removed and shall be reimbursed at the applicable drug code rate listed on the Physician Administered Drug Program (PADP) fee schedule
  • Physician Fee Schedule | CMS - Centers for Medicare Medicaid Services
    CMS issued the CY 2025 Physician Fee Schedule (PFS) final rule to update Medicare PFS See a summary of provisions effective January 1, 2025 The PFS is the primary method of payment for enrolled health care providers
  • Health Plan Billing Guidance - Version 26 - NC Medicaid
    - Ensure consistency in provider billing practices for key Medicaid services, and - Allow for accurate and complete NC Medicaid and Centers for Medicare Medicaid Services (CMS) reporting The billing guide references requirements to adhere to NC Medicaid Direct and NC Health Choice clinical


















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