North Carolina

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NC FEE Schedules

SUCCESS

Run Date and Time

Jun 01, 2026

2m 45s

Run Metrics

New2
Changed0
Unchanged106
Checked108

Fee Schedule Impacts

High0
Medium2
Low0

Run summary

This run for North Carolina Medicaid / NC_FEE_SCHEDULES identified 0 changed documents and 2 newly discovered documents. 1 newly discovered item(s) appear current or upcoming.

High Impact (0)

No documents in this severity group.

Medium Impact (2)

Durable Medical Equipment.xlsx

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The document is a revised fee schedule for Durable Medical Equipment (DME) in North Carolina, effective May 1, 2026. It includes specific rates for various items, effective from October 1, 2025.

Highlights

  • New DME fee schedule effective May 1, 2026.
  • Rates effective from October 1, 2025, for items like tracheostoma filters and blood pressure monitors.
  • Providers should bill usual and customary rates, not exceeding maximum reimbursement.
  • Includes taxonomies and specialties relevant to DME billing.

Reason

The document outlines future rate changes effective in 2025 and 2026, which are not immediately urgent but relevant for planning.

Watch items

May 1, 2026October 1, 2025A4481A4604A4670

Nursing Facility Rates_Short Stay Managed Care..xlsx

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The document outlines new Medicaid managed care short stay rates for skilled nursing facilities in North Carolina, effective from April 1, 2025, to June 30, 2025. It includes specific per diem rates for various facilities.

Highlights

  • Effective dates: April 1, 2025 - June 30, 2025
  • Applies to managed care health plan reimbursement
  • Specific per diem rates listed for multiple facilities
  • Includes provider appeal rights information

Reason

The changes are not effective immediately, but they include specific rate updates for future implementation.

Watch items

April 1, 2025June 30, 2025Per diem ratesManaged care reimbursement
Low Impact (0)

No documents in this severity group.