North Carolina Medicaid: New state requirement to receive payment for obstetrical services
To comply with state requirements, beginning July 1, practices that provide prenatal and postpartum care services to UnitedHealthcare Community Plan of North Carolina members will need to use F codes to receive payment for these claims.
What this means for you
After July 1, 2025, we’ll deny delivery claims, including global or package billing codes, submitted to North Carolina Medicaid Direct and Managed Care Plans without a code for 0500F (Initial Prenatal Care Visit).
Reason for the requirement
The state implemented this change because current global billing processes fail to capture when initial prenatal or postpartum care begins. Implementing these codes will help enable North Carolina Medicaid and Managed Care Plans to gather essential data aligning with North Carolina and National Committee for Quality Assurance standards concerning prenatal and postpartum care.
Resources
The following resources are available to help you understand the new requirement and how to implement it into your practice:
Questions? We’re here to help
If you have questions, email North Carolina Area Health Education Centers at practicesupport@ncahec.net.
PCA-1-25-01249-C&S-NN_06112025
