Practice Support Update Blog

NC Medicaid Tailored Plans go live July 1, 2024: What you need to know

Feb 20, 2024 8:30:00 AM / by Practice Support Team


North Carolina Medicaid Division of Health Benefits (DHB) has announced that Tailored Plans (the health plans for qualifying members with mental health needs, substance use disorders, intellectual/developmental disabilities or traumatic brain injuries) will start on July 1, 2024.

What do you need to do?

  • Be aware of which of the Local Management Entities / Managed Care Organizations (LME/MCOs) serve your region. Keep in mind your patients may live in a neighboring county that is served by a different entity.

  • Contract with these entities. Keep in mind that credentialing may take some time.

  • Consider that given the recent LME/MCO consolidation, much has changed. You may need to make new connections. 

If you do not have a contract for the Tailored Plan network, you will be considered 'out-of-network' and subject to reduced reimbursement rates for physical services.


Have questions?


LME/MCO Directory


Tailored Plan Services page


Tags: Medicaid Managed Care, Primary Care, practice management, Tailored Plans

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