Billing Codes & Rates | Check Write Schedule

Fee Schedule Update and Claim Reprocessing Announcement

Trillium Health Resources has published an updated Fee Schedule which reflects the NCDHHS Medicaid Rate Reductions of 3%, 8%, and 10% effective October 1, 2025. Please begin using these updated rates immediately.

Starting November 1, 2025, claims submitted for dates of service October 1, 2025 forward at rates higher than the reduced Medicaid fee schedules will be reprocessed to align with the updated fee schedule.

Please note:

• The rate reductions have been applied to each provider’s rates in effect as of September 30, 2025.
• The rate changes also apply to all ILOS services, member-specific rates, and provider-specific rates.
• Impacted Medicaid reimbursement claims submitted above Trillium’s published rates after October 1, 2025 will be reprocessed retroactively.  There is no action needed by the provider at this time.
• Updated claims will be reflected in your Remittance Advice once processed.

Additional details regarding the services impacted and the base rate assumptions can be found here: NC Medicaid Rate Reductions.

For questions regarding these rate adjustments, please contact the Rates Team at: RatesFinance@TrilliumNC.org.