On January 8, 2024, North Carolina Medicaid began allowing pharmacists, who provide care and prescribe medications via statewide protocols, to enroll as healthcare providers. Prior to this date, and since 2018, clinical pharmacist practitioners, working under a collaborative agreement, have been allowed to enroll as NC Medicaid providers.
The North Carolina Association of Pharmacists coordinated the legislative work that led to the passing of State Law 2021-110, which grants authority to pharmacists to prescribe certain medications. North Carolina Medicaid is the first health plan to recognize pharmacists as qualified health care providers and to begin paying for care permitted by the profession’s legal scope of practice.
Each tab on this page is designed to guide pharmacists through the steps for provider enrollment with North Carolina Medicaid and the submission of medical claims for North Carolina Medicaid beneficiaries. The videos below, recorded during NCAP-hosted webinars on February 20, 2024, and December 15, 2024, complement the information provided on these pages. They offer additional clarity to help users navigate the enrollment and medical billing processes.
See the February 20th Webinar recording Medicaid Pharmacist-Provider Enrollment & Billing for Contraceptive Care for:
Background leading to pharmacist provider enrollment with NC Medicaid
Requirements and information to support successful enrollment
Information on taxonomies for pharmacies vs pharmacists vs. CPPs
See December 15th Webinar recording Unlocking Opportunities: NC Medicaid Provider Enrollment and Medical Billing Essentials for NC Pharmacists to:
1. Explain the importance of pharmacist provider enrollment in advancing pharmacy practice in North Carolina. 2. Identify the key requirements and documentation for pharmacist provider enrollment. 3. Identify common enrollment challenges and suggest strategies to overcome them. 4. Outline key considerations for billing medical claims across the 10 NC Medicaid plans. 5. Explain the billing differences among the 10 NC Medicaid plans and their implications for pharmacists.
Important! The Emergency Prescription Assistance Program (EPAP), activated in response to Hurricane Helene, will officially end on May 31. NC DHHS has issued a memo with important information for pharmacists and clinicians regarding the conclusion of the program, along with resources to support patients who have been utilizing EPAP.You can access it directly on the NC DHHS Hurricane Helene Provider Resources webpage under Notices and Alerts. Please review and share this information with your teams and patients as needed.
