North Carolina Medicaid Lab & Imaging Fee Schedule 2026

North Carolina Medicaid publishes 1,935 lab & imaging procedure rates effective 2026, paying a median 100.3% of the national Medicare amount for the same services. This page shows published rates for common lab & imaging procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full North Carolina lab & imaging schedule has 1,935 codes.

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Published codes

1,935

Lab & Imaging procedures on the 2026 schedule

Median % of Medicare

100.3%

vs national Medicare, GPCI-neutral

Effective vintage

2026

latest effective year on the schedule

Common lab & imaging procedures and what North Carolina Medicaid pays

A curated sample of recognizable procedures from the 1,935-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.

CodeProcedureNorth Carolina rate% of Medicare
70110Jaw (mandible) X-ray, 4 or more views$30.3470.4%
70140Facial bone X-ray, under 3 views$22.9372.3%
70160Nasal bone X-ray$24.4665.4%
70220Sinus X-ray, 3 or more views$29.9779.4%
70360Neck soft tissue X-ray$20.8367.1%
70450CT scan of the head without contrast$168.92158.5%
70480CT scan of the eye socket or inner ear without contrast$257.27162.5%
70486CT scan of the face and sinuses without contrast$217.59169.6%
70491CT scan of neck soft tissue with contrast$258.74141.1%
70551MRI of the brain without contrast$439.57225%
70553MRI of the brain without then with contrast$654.29206.4%
71045Chest X-ray, 1 view$16.2464%
71046Chest X-ray, 2 views$24.9475.4%
71047Chest X-ray, 3 views$31.9377.7%
71048Chest X-ray, 4 or more views$34.2976%
71100Rib X-ray, one side$25.2470%
71250CT scan of the chest without contrast$220.47166.3%
71260CT scan of the chest with contrast$264.33158.6%
71275CT angiography of the chest$402.71143.5%
72040Neck (cervical) spine X-ray, 2-3 views$28.3171.2%
72070Mid-back (thoracic) spine X-ray, 2 views$26.0778.8%
72100Lower back (lumbar) spine X-ray, 2-3 views$29.7173.5%
72110Lower back (lumbar) spine X-ray, 4 or more views$41.5077.7%
72125CT scan of the neck (cervical) spine without contrast$221.02169.2%
72131CT scan of the lower (lumbar) spine without contrast$220.19169.5%

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

Lab & Imaging rates in neighboring states

Frequently asked questions

What does North Carolina Medicaid pay for laboratory tests and imaging?

North Carolina Medicaid publishes 1,935 lab & imaging procedure rates effective 2026, paying a median 100.3% of the national Medicare amount for the same services. The schedule covers blood panels, urinalysis, X-rays, CT, MRI, and ultrasound. 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 lab & imaging rates compare with Medicare?

Across lab & imaging codes with a national Medicare comparator, North Carolina Medicaid pays a median 100.3% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.

Do lab & imaging 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.