North Carolina Medicaid Other Services Fee Schedule 2026

North Carolina Medicaid publishes 91 other services procedure rates effective 2026, paying a median 91.6% of the national Medicare amount for the same services. This page shows published rates for common other services 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 other services schedule has 91 codes.

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Published codes

91

Other Services procedures on the 2026 schedule

Median % of Medicare

91.6%

vs national Medicare, GPCI-neutral

Effective vintage

2026

latest effective year on the schedule

Common other services procedures and what North Carolina Medicaid pays

A curated sample of recognizable procedures from the 91-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

Other Services rates in neighboring states

Frequently asked questions

What does North Carolina Medicaid pay for other covered services?

North Carolina Medicaid publishes 91 other services procedure rates effective 2026, paying a median 91.6% of the national Medicare amount for the same services. The schedule covers clinic encounters, screenings, and state-specific service 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 other services rates compare with Medicare?

Across other services codes with a national Medicare comparator, North Carolina Medicaid pays a median 91.6% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.

Do other services 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.