Are You Billing Medicaid at the Correct Rate? 

NCHCFA received a call from a provider wanting to clarify which rate they should be billing for their Medicaid residents.  There seems to be confusion with some providers because of the mis-leading column headings used in the fee schedules.  

When reviewing the nursing facility fee schedules posted by Medicaid, nursing facilities should be billing the amount in the column on the extreme right side of the schedule.  This should be the rate that includes the $47.50.  The $47.50 has been in place for all nursing facilities, regardless of outbreak status, for dates of service between January 1, 2022 and December 31, 2022.  

The Medicaid fee schedules have traditionally been posted at https://medicaid.ncdhhs.gov/providers/fee-schedules/nursing-facility-fee-schedules-archive.  More recent fee schedules are posted at https://ncdhhs.servicenowservices.com/fee_schedules.  

If you have any questions, please contact Sam Clark at samc@nchcfa.org.