North Carolina Medicaid LTSS / Waiver Fee Schedule 2025

North Carolina Medicaid publishes 13 ltss / waiver procedure rates effective 2025 on its fee-for-service schedule. This page shows published rates for common ltss / waiver 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 ltss / waiver schedule has 13 codes.

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Published codes

13

LTSS / Waiver procedures on the 2025 schedule

Median % of Medicare

--

no national Medicare comparator for this category

Effective vintage

2025

latest effective year on the schedule

Common ltss / waiver procedures and what North Carolina Medicaid pays

A curated sample of recognizable procedures from the 13-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

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

LTSS / Waiver rates in neighboring states

Frequently asked questions

What does North Carolina Medicaid pay for long-term services and supports?

North Carolina Medicaid publishes 13 ltss / waiver procedure rates effective 2025 on its fee-for-service schedule. The schedule covers personal care, attendant services, day habilitation, and waiver program services. 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 ltss / waiver rates compare with Medicare?

Most ltss / waiver 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 ltss / waiver 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 2025), 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.