NC Medicaid Implements 5 percent Rate Increase

June 17, 2020

The NC General Assembly’s recently approved HB 1043—2020 COVID-19 Recovery Act includes a 5 percent rate increase for all Fee-For-Service (FFS) Medicaid providers who had not yet received a 5 percent increase during the COVID-19 public health emergency.

The rate increases are effective March 1, 2020, and will be applied retroactively to claims already submitted with a date of service on or after March 1, 2020. This increase will end when either the nationwide public health emergency expires; the state’s Declaration of Emergency related to COVID-19 ends or March 31, 2021, whichever comes first.

The rate increases only applies to Medicaid and NC Health Choice services billed through NCTracks and do not apply to behavioral health and I/DD services billed to local management entities/managed care organizations (LME/MCOs). Only those providers who have not previously received rate increases implemented under the Medicaid Disaster State Plan Amendment (SPA) submitted to the Centers for Medicare & Medicaid Services (CMS) in April are eligible for this rate increase.

More information is available in SPECIAL BULLETIN COVID-19 #99: North Carolina General Assembly Mandates Temporary 5 percent Rate Increase for Certain Medicaid Providers