Reminder: Nursing Facility Payment Changes Effective Sept. 1, 2025

NC Medicaid is streamlining the nursing facility payment process to support timely provider reimbursement and reduce administrative delays.

Key Updates:

• MAGI Members: Providers can bill immediately upon admission. No DSS action or PML determination is required.
• All Members: Payment is no longer delayed by the transfer of assets evaluation. Claims can be paid once PML is determined (for non-MAGI members).
• Sanctions from asset evaluations will apply starting the date listed on the DSS-8110 notice, always ending on the last day of the month.

For more information, read the full bulletin: NF Payments Bulletin

 

 

 

 

 

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