North Carolina Division of Health Benefits officially notified Vaya Health of upcoming changes to the NC Medicaid fee schedule rates effective October 1, 2025. The new detailed fee schedule changes have not yet been provided.
Vaya Health notified network providers in their recent bulletin that it will update their systems to implement the fee schedule changes no earlier than November 1, 2025. If there is no legislative agreement by October 31, Vaya will implement the rate cuts on November 1, retroactive to the effective date of October 1. On that date they plan to update their systems to pay at the newly published rates, and will take steps to recoup the difference in reimbursement for services provided back to October 1.
Vaya indicated they will issue more detailed communications soon, and provided links to email them with questions as well as a link to join the Vaya Provider Touchpoint webinar on October 3rd.
