The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full North Carolina drugs schedule has 369 codes.
- Every code on all 51 published schedules
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Published codes
369
Drugs procedures on the 2026 schedule
Median % of Medicare
--
no national Medicare comparator for this category
Effective vintage
2026
latest effective year on the schedule
Common drugs procedures and what North Carolina Medicaid pays
A curated sample of recognizable procedures from the 369-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | North Carolina rate | % of Medicare |
|---|---|---|---|
| J0696 | Injection, ceftriaxone sodium, per 250 mg | $0.40 | -- |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | $0.09 | -- |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | $0.29 | -- |
| J2550 | Injection, promethazine hcl, up to 50 mg | $3.64 | -- |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | $0.68 | -- |
| J7030 | Infusion, normal saline solution , 1000 cc | $2.18 | -- |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.
More North Carolina Medicaid fee schedules
- North Carolina physician fee schedule · 6,547 codes
- North Carolina lab & imaging fee schedule · 1,935 codes
- North Carolina dme & supplies fee schedule · 1,051 codes
- North Carolina other services fee schedule · 91 codes
- North Carolina vision fee schedule · 47 codes
- North Carolina behavioral health fee schedule · 24 codes
Drugs rates in neighboring states
Frequently asked questions
What does North Carolina Medicaid pay for physician-administered drugs?
North Carolina Medicaid publishes 369 drugs procedure rates effective 2026 on its fee-for-service schedule. The schedule covers injectable and infused medications billed under HCPCS J-codes. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do North Carolina's drugs rates compare with Medicare?
Most drugs codes in this category have no direct national Medicare comparator (Medicare prices these services through different mechanisms), so a median comparison is not published here.
Do drugs services need prior authorization in North Carolina?
North Carolina does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".
Where do these rates come from?
Directly from North Carolina's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time North Carolina changes these rates.