Changes to the North Carolina Medicaid Behavioral Health Services Fee Schedule
Dear Provider,
NC Medicaid (Division of Health Benefits), under the North Carolina Department of Health and Human Services, has made some changes to the Behavioral Health Services Fee Schedule. These changes became effective 1/1/2024. WellCare of North Carolina, Inc. has been working with the Department on these changes and ensuring that our system is setup to administer the changes. Below is an FAQ which provides a high-level overview of commonly asked questions and contact information for our teams. We value your partnership and look forward to a great working relationship in 2024.
Q: The new rates apply to which codes/services?
A: The rate increases include E/M codes, assessment and psychological/neuropsychological testing codes, psychotherapy services and enhanced services, inpatient per diem rates, and in lieu of services. For all services with dates of service from 1/1/24 and beyond, WellCare has implemented the new rates statewide. View the new statewide rates on the State website.
Q: I have services that were rendered after 1/1/24 but were not paid the rates that went into effect on 1/1/24. Do I need to resubmit those claims?
A: Upon completion of all related fee schedule enhancements, the impacted claims will be identified and reprocessed through our internal workflow processes. Additionally, providers are not expected to resubmit claims received and processed prior to the system fee schedule enhancements being completed. Claim reprocessing efforts are expected to be completed in accordance with state regulations and guidance.
Q: Who should I reach out to if I have questions?
A: Should you have any questions or require further clarification, please do not hesitate to reach out to WellCare at ncproviderrelations@wellcare.com.
We believe that these changes will better align reimbursement rates with the evolving needs of our beneficiaries and providers. We appreciate your cooperation and understanding during this transition period.
Thank you for your continued commitment to providing exceptional care to Medicaid beneficiaries.
Sincerely,
WellCare of North Carolina