fbpixel North Carolina Home Care Medicaid Eligibility & Guidelines

Everything You Want To Know

Medicaid / North Carolina

Medicaid for Home Care in North Carolina

Medicaid Certified Home Care Agency in North Carolina

As a home care agency, one needs to be certified as an HHA (Home Health Agency) to bill Medicaid in NC. It is critical for a homecare agency to have proper certification and license when they are delivering services and seeking reimbursement. There are certain regulations that are followed by every state, but each state also has its own requirements. One can check the details offered by the state’s Department of Human Services or Bureaus of Licensing and Certification.

Governing Body: North Carolina Department of Health and Human Services


In North Carolina, Medicaid programs are funded by the state and federal governments to provide health coverage to people aged 65 or older as well as to seniors, parents, children, blind, disabled people, and caregivers.

Medicaid Programs:

  • Health Choice
  • Community Alternatives Program for Disabled Adults (CAP/DA) Waiver
  • Community Alternatives Program / Choice
  • Personal Care Services (PCS)

Income Requirements:

  • For the aged, blind or disabled people, income within 100% of the FPL ($1,005 per month) for an individual and $1,354 per month for a family of two. The FPL limit increases to 150% if a disabled is working
  • For families with infants and children below 5 years, income up to $2,842 per month for a family of two and $5,037 per month for a family of five
  • For families with dependents aged 19 or 20, income up to –
    • $434 for a family of one
    • $569 for a family of two
    • $667 for a family of three
    • $744 for a family of four
  • For pregnant women, income from $2,653 to $4,018

Application Process:

The application process for accessing Medicaid in North Carolina is easy, and anyone can apply for the available Medicaid programs by visiting the Division of Social Services.

Medicaid with CareSmartz360

Home care businesses require advanced solutions to integrate Medicaid into their services, and Caresmartz has been doing that across the states for home care agencies, private-duty care providers, and home care franchisors for several years. CareSmartz360 is a complete software solution to manage a home care business, and it supports all Medicaid payers, allowing businesses to focus on other operations and processes.

  • Effective and comprehensive management of the revenue cycle.
  • Allows agencies to fulfill billing requirements for Medicaid, Medicare, Insurance, and Private Pay.
  • Built-In feature to submit claims electronically.
  • Quickly create, review, approve and submit claims in paper invoice or 837P, 837I format.
  • Helps in generating error-free claims to save time and efforts.
  • Identify and manage accounts and claims that are overdue.
  • Robust reporting to evaluate financial performance.
Request a Demo

    50-State Medicaid Guide

    Be Medicaid Ready with CareSmartz360
    • Create, Review & Approve Claims
    • Automatic Claim Submission
    • Supports All Medicaid Payers
    • Error-free Claims to Avoid Denials
    • Claims submission in 837P, 837I format

    We've just scratched the surface.

    Our users reported 95% customer satisfaction in 2023. Schedule a personal walkthrough to see CareSmartz360 in action.

    Request a Demo