North Carolina
highNC FEE Schedules
Run Date and Time
May 01, 2026
1m 48s
Run Metrics
Fee Schedule Impacts
Run summary
This run for North Carolina Medicaid / NC_FEE_SCHEDULES identified 0 changed documents and 5 newly discovered documents. 1 item(s) are high priority. 5 newly discovered item(s) appear current or upcoming.
High Impact (1)
Hospital Provider Outpatient RCC.xlsx
The document outlines new Medicaid outpatient rates for various hospitals in North Carolina, effective from October 1, 2025, to June 30, 2026. It includes specific rate changes for several facilities, impacting reimbursement rates.
Highlights
- •New outpatient rates effective October 1, 2025.
- •Rates valid through June 30, 2026.
- •Includes specific rates for multiple hospitals.
- •No rate reductions included in this schedule.
Reason
The document contains specific rate changes effective soon, impacting reimbursement.
Watch items
Medium Impact (4)
Hospital Rehab Per Diem.xlsx
The document outlines the rehab per diem fee schedule for North Carolina Medicaid, effective from October 1, 2025, to June 30, 2026. It includes specific rates for various hospitals and notes that these rates do not contain reductions.
Highlights
- •Rehab per diem fee schedule for NC Medicaid.
- •Effective from October 1, 2025, to June 30, 2026.
- •Rates do not include reductions.
- •Specific rates listed for multiple hospitals.
Reason
The document is current but the effective date is not imminent, and it lacks immediate reimbursement impact.
Watch items
Hospital Psych Per Diem.xlsx
The document outlines a new psych per diem fee schedule for North Carolina Medicaid, effective from October 1, 2025, to June 30, 2026, with a base rate of $895.63. Providers must be reimbursed at least 100% of this rate unless an alternative arrangement is agreed upon.
Highlights
- •New psych per diem fee schedule effective October 1, 2025.
- •Base rate set at $895.63 per diem.
- •Applies to North Carolina Medicaid providers.
- •Reimbursement must be at least 100% of the base rate unless otherwise agreed.
- •Effective through June 30, 2026.
Reason
The changes are not immediately effective but will impact reimbursement rates starting in 2025.
Watch items
Hospital DRG Base Rate.xlsx
The document outlines updated DRG base rates for North Carolina Medicaid, effective from October 1, 2025, to June 30, 2026. It includes specific rates for various hospitals and mentions the transition to DRG Grouper V44 on October 1, 2026.
Highlights
- •DRG base rates effective October 1, 2025, to June 30, 2026.
- •Transition to DRG Grouper V44 on October 1, 2026.
- •Specific rates listed for multiple hospitals.
- •No rate reductions included in the schedule.
Reason
The changes are not immediately effective but are relevant for future planning and budgeting.
Watch items
Hospital Provider Inpatient RCC.xlsx
The document outlines the inpatient RCC fee schedule for North Carolina, effective from October 1, 2025, to September 30, 2026. It includes specific rates for various hospitals and notes the transition to DRG Grouper V44 on October 1, 2026.
Highlights
- •Effective date: October 1, 2025 - September 30, 2026
- •Transition to DRG Grouper V44 on October 1, 2026
- •Specific RCC rates listed for multiple hospitals
- •No rate reductions included in the schedule
Reason
The document is current but changes are not immediately effective, and it primarily provides future rate information.
Watch items
Low Impact (0)
No documents in this severity group.