State to increase payment rates to long-term care providers

Published 9:57 am Thursday, March 26, 2020

Getting your Trinity Audio player ready...


RALEIGH — The North Carolina Department of Health and Human Services (NCDHHS) Division of Health Benefits (NC Medicaid) will temporarily increase payments rates to long-term care providers and facilities to support them in caring for Medicaid beneficiaries who are at high risk of serious illness from COVID-19. Medicaid will also be temporarily increasing rates to behavioral health, intellectual and developmental disability and specialized therapy providers for vulnerable children and adults in outpatient and residential settings.

This temporary rate increase will allow long-term services providers to implement additional measures to protect the health of those they serve in this time of crisis. Long-term care facilities have been asked to set up isolation space for residents who test positive with COVID-19, proactively monitor staff for symptoms of COVID-19 and provide masks to residents with any type of respiratory symptoms.

To ensure access to behavioral health, I/DD and specialized therapy providers for vulnerable children and adults in outpatient and residential settings, local management entities/managed care organizations (LME-MCOs) agencies will receive a temporary increase in their rates and can use the funds to address community gaps in services such as purchasing needed teletherapy equipment.

“Our Medicaid providers are among the many heroic health care professionals on the front line of North Carolina’s response to COVID-19,” said NCDHHS Secretary Mandy Cohen, M.D. “We are working with those who serve our most vulnerable to give them the additional financial support they need to respond to the COVID-19 crisis.”

To target some of the most vulnerable Medicaid beneficiaries, the following Medicaid providers and services will receive a 5 percent increase in fee-for-service reimbursement rates, retroactive to March 10, 2020: skilled nursing facilities; hospice facilities; health departments; home health and private duty nursing; personal care services; physical, occupational, speech and audiology therapy; Program of All-inclusive Care for the Elderly (PACE); and Community Alternatives for Children (CAP/C) and for Adults (CAP/DA). LME-MCOs will receive a 1.5 percent increase in their per person rate effective April 1, 2020.

NC Medicaid is also pursuing hardship support to rural, independent hospitals as needed. The NC Medicaid team is working with affected providers on a case-by-case basis.

For more information on NC Medicaid COVID-19 policy modifications, visit the Medicaid website at Current COVID-19 guidance and resources are available online at