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Copays for Medicaid and NC Health Choice

Friday, April 24, 2020   (0 Comments)
Posted by: Kay Castillo
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From the North Carolina Department of Health and Human Services:

Suspending copays on COVID-19 related services. NCDHHS is directing providers to stop collecting copayments from Medicaid and NC Health Choice beneficiaries on all COVID-19 related testing, services and treatments. Effective retroactive to Jan. 1, 2020, this suspension is required of states taking advantage of federal Medicaid funding available through the federal Families First Coronavirus Response Act passed March 18, 2020. Providers who have already collected copays for COVID-19 related services should make every effort to return those payments to beneficiaries.

NC Medicaid will reimburse providers for lost copay revenue. The reimbursement method and timing will be announced in the future. Note that providers can continue to collect copays for non-COVID-19 related services.


A list of affected billing codes, direction about managing copays already collected, and other important information is included in SPECIAL BULLETIN COVID-19 #62: Clinical Policy Modifications – Suspending Copays on COVID-19-related Services.

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