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08/03/2026
Rate Increases for Personal Care Services (PCS)
The 2026 Appropriations Act (Senate Bill 257, Section 9E.15) appropriated $70.8 million in recurring State funding to raise PCS rates. The legislation does not set a rate or percentage; therefore, the Division of Health Benefits applied a uniform 18% increase to all applicable procedure codes. That percentage distributes the full appropriation across the remaining 11 months of state fiscal year (SFY) 2027.
These rate increases also apply to PCS furnished by providers contracted with Standard Plans and Tailored Plans. Health plans have 45 calendar days from the date DHB notifies them to load the new rates, plus 30 additional days to reprocess claims with dates of service on or after Aug. 1, 2026.
These rates are now loaded into the Alliance Claims System with an effective date of 8/1/2026. Providers may begin billing the new rate of $7.03 per unit on 8/4/2026. Any claims already submitted will be re-adjudicated by Alliance. No action is needed by providers.
The applicable PCS codes are posted on the publicly posted fee schedule. NC Medicaid is revising the published fee schedules to reflect the rates shown.
