Useful information for health care providers
Documents and links on understanding and working with North Carolina's Medicaid program and policies
Overview: If you are new to NC's Medicaid program, please start with this overview.
Medicaid sign up: Health care providers who have not yet signed up to participate in the NC Medicaid program should go here.
Billing Guide, general: For the best overall guide, please go to the NCTracks Provider Claims and Billing Assistance Guide. This is a long but readable summary of the program. You can read the entire manual or just click on the chapters that you find relevant. If you have read this before, just click on the "Summary of Changes." The Guide is updated in October and April of each year.
Medicaid Resource Guide 2012: An online guide to Medicaid resources for CCNC Care Managers, including links to Medicaid policies and procedures.
Medicaid Preferred Drugs List: Find the DMA's 2018 lists here.
Drugs of Choice (DOC) List: The DOC List was created by Community Care of North Carolina and the North Carolina Physician's Advisory Group in response to requests from prescribers for a "hassle free" list of medications that may be used across payers and the uninsured. All medications listed on the DOC List are designated as preferred medications by NC Medicaid and designated as preferred or tier 1 by BCBS of NC, NC State Health Plan, and NC Health Choice.
Medicaid Prior Authorization Forms: List of medications requiring PA forms, and the forms themselves, can be found here.
Bulletins: Providers are strongly encouraged to bookmark the Medicaid Bulletins page to keep apprised of policy and coding changes. You may also find it helpful to sign up for NCTracks Communications.
Consumer Guides: There is also a wealth of information available in the Medicaid Consumer Guides. (Scroll down just below the Consumer Notices.) Information is separated by population served by the program (e.g., women and children, Aged, Blind and Disabled, etc.)