North Carolina CAP Medicaid Enrollment Changes

North Carolina CAP providers should take action now. NC Medicaid has announced critical enrollment updates that affect Case Managers and Care Coordinators delivering services under the Community Alternatives Program (CAP), including CAP for Children, CAP-Consumer Direction, and CAP for Disabled Adults.

These changes require individual provider enrollment and must be completed by March 1, 2026, to avoid billing delays or service disruptions.

Who Is Affected by North Carolina CAP Enrollment Changes?

These NC Medicaid updates apply to Case Managers and Care Coordinators providing services under:

• Community Alternatives Program (CAP)
• North Carolina CAP – Consumer Direction
• North Carolina CAP for Children
• North Carolina CAP for Disabled Adults

If you work within any North Carolina CAP program, these enrollment changes directly impact you or your organization.

What Changed in North Carolina CAP Medicaid Enrollment?

NC Medicaid clarified that the Case Manager/Care Coordinator taxonomy (171M00000X) is only permitted for individual providers.

What This Means Going Forward

• Individuals must use taxonomy 171M00000X
• Organizations may no longer use taxonomy 171M00000X
• Organizations must instead enroll using taxonomy 251B00000X

NCTracks will enforce this change. Eligibility requirements can be found in the Provider Permission Matrix on the NCTracks Provider Enrollment webpage.

For the full announcement, visit the NC Medicaid announcement page.

What Individual Case Managers and Care Coordinators Must Do

If you provide services under North Carolina CAP, you must be enrolled as an individual provider in NCTracks.

Required Steps for Individual Providers

1. Obtain an Individual NPI — Apply through the National Plan and Provider Enumeration System (NPPES) if you don’t already have one.

2. Enroll in NCTracks as an Individual Provider — Use taxonomy 171M00000X during enrollment.

3. Affiliate with Your Organization’s Billing NPI — This allows your employer or agency to bill for services you provide. You can affiliate during enrollment or submit a Manage Change Request later in NCTracks.

Failure to complete these steps could result in interrupted billing or denied claims for North Carolina CAP services.

What Organizations Providing North Carolina CAP Services Must Do

Organizations currently enrolled using taxonomy 171M00000X must update their enrollment records to remain compliant.

Required Actions for Organizations

• Remove taxonomy 171M00000X
• Add taxonomy 251B00000X
• Submit changes via a Manage Change Request in NCTracks

These updates are mandatory for organizations supporting North Carolina CAP Case Management and Care Coordination services.

Deadline to Stay Compliant with North Carolina CAP Medicaid

All enrollment updates must be completed by March 1, 2026.

Missing this deadline may lead to:

• Billing disruptions
• Delayed reimbursements
• Service interruptions for North Carolina CAP participants

Need Help Navigating North Carolina CAP Enrollment Changes?

If you have questions about North Carolina CAP Medicaid enrollment, individual NPIs, or NCTracks change requests, our GeoH agency specialists are here to help.

Contact one of our specialists today to make sure your enrollment is up to date before the deadline.