GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H D
HOUSE BILL DRH50009-NLa-16B
Short Title: Increase Medicaid PCS and PDN Rates. (Public)
Sponsors: Representative White.
Referred to:
*DRH50009 -NLa-16B*
A BILL TO BE ENTITLED 1
AN ACT TO INCREASE MEDICAID REIMBURSEMENT RATES FOR PERSONAL CARE 2
SERVICES AND PRIVATE DUTY NURSING SERVICES . 3
The General Assembly of North Carolina enacts: 4
SECTION 1. There is appropriated from the General Fund to the Department of 5
Health and Human Services, Division of Health Benefits, the sum of one hundred nineteen 6
million two hundred thousand dollars ($119,200,000) in recurring funds for each year of the 7
2025-2027 fiscal biennium to be used to increase to seven dollars and fifty cents ($7.50) per 8
15-minute increment the Medicaid rate paid for personal care services pursuant to Medicaid 9
Clinical Coverage Policies 3L, 3K-1, and 3K-2 provided to Medicaid beneficiaries through the 10
State Plan Personal Care Services Program (PCS), Community Alternatives Program for 11
Children (CAP/C), Community Alternatives Program for Disabled Adults (CAP/DA), and 12
Community Alternatives Program Choice (CAP/CO). These funds shall provide a State match 13
for two hundred seventeen million eight hundred thousand dollars ($217,800,000) in recurring 14
federal funds for each year of the 2025-2027 fiscal biennium, and those funds are appropriated 15
to the Division of Health Benefits for the same purpose. 16
SECTION 2. There is appropriated from the General Fund to the Department of 17
Health and Human Services, Division of Health Benefits, the sum of nineteen million eight 18
hundred thousand dollars ($19,800,000) in recurring funds for each year of the 2025-2027 fiscal 19
biennium to be used to increase to sixteen dollars and twenty-five cents ($16.25) per 15 minutes 20
the Medicaid rate paid for private duty nursing services pursuant to Medicaid Clinical Coverage 21
Policies 3G-1: Private Duty Nursing for Beneficiaries Age 21 and Older and 3G-2: Private Duty 22
Nursing for Beneficiaries Under 21 Years of Age. These funds shall provide a State match for 23
thirty-six million two hundred thousand dollars ($36,200,000) in recurring federal funds for each 24
year of the 2025-2027 fiscal biennium, and those funds are appropriated to the Division of Health 25
Benefits for the same purpose. 26
SECTION 3. This act becomes effective July 1, 2025. 27
H.B. 453
Mar 18, 2025
HOUSE PRINCIPAL CLERK