Well Child Visits Added as Core Services for Federally Qualified Health Center/Rural Health Center Claims

Effective Nov. 9, 2025, retroactive back to May 1, 2024, Federally Qualified Health Center (FQHC) and Rural Health Center (RHC) providers will be reimbursed for Well Child Visit procedure codes (99381EP-99385EP; 99391EP-99395EP) as a core service. Ancillary codes with a $0 rate on the Fee-for-Service (FFS) FQHC RHC Non Core - Well Child fee schedule will be accepted on same claim with the well child visit. Ancillary codes with a rate > $0, eligible for separate reimbursement, must continue to be billed on a separate claim from the core visit, T1015, or well child visit.

Additional details on this new reimbursement method can be found at the following link:

https://medicaid.ncdhhs.gov/blog/2025/07/03/updated-federally-qualified-health-centers-and-rural-health-clinics-reimbursement-methodology