Every state, kept current
The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full North Carolina state-specific services schedule has 91 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Published codes
91
state-specific and temporary HCPCS codes on the 2026 schedule
Median % of Medicare
91.6%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common state-specific and temporary HCPCS codes 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.
| Code | Procedure | North 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
- North Carolina Medicaid fee schedule 2026, all categories
- 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 drugs fee schedule · 369 codes
- North Carolina vision fee schedule · 47 codes
- North Carolina behavioral health fee schedule · 24 codes
State-Specific Services rates in neighboring states
Frequently asked questions
What does North Carolina Medicaid pay for state-specific and temporary HCPCS services?
North Carolina Medicaid publishes 91 state-specific and temporary HCPCS code rates effective 2026, paying a median 91.6% of the national Medicare amount for the same services. The schedule covers clinic and screening encounters, telehealth facility fees, personal care, and other C, Q, S and T 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 state-specific services rates compare with Medicare?
Across state-specific 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 state-specific and temporary HCPCS 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.