MedicaidAdministrativeHigh impact
North Carolina Medicaid: State upholds EVV transmission requirements
UnitedHealthcare·NC · Home Health·State news
We identified it
Jun 13, 2026
Summary
North Carolina Medicaid requires home health providers to complete two submissions for encounter visits: transmit EVV (Electronic Visit Verification) data to HHAeXchange and submit claim information to UnitedHealthcare. EVV service codes must exactly match prior authorization and claim submissions, and providers must use taxonomy code 251E00000X or claims will be denied.
Action Required
Immediately: Home health providers must ensure EVV service codes transmitted to HHAeXchange exactly match UnitedHealthcare prior authorization and claim submissions. Verify taxonomy code 251E00000X is used on all claims (other codes will result in denial). Choose either 1-step integrated billing through HHAeXchange or 2-step direct billing through EDI clearinghouse. Monitor visit import failures, check claim status regularly, and use appropriate service type, revenue code and HCPC/CPT codes from the UnitedHealthcare Community Plan crosswalk.