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MedicaidReimbursementHigh impact

Enhanced Primary Care (EPC) Program and Fee Schedule Discontinuance

Nebraska Medicaid·NE · Family Medicine, General Practice, Internal Medicine·Claims & Billing
Effective date
Jul 1, 2026
We identified it
Jun 21, 2026
Days to comply
9 days

Summary

Nebraska Medicaid is discontinuing its Enhanced Primary Care (EPC) program effective July 1, 2026. EPC providers will automatically be disenrolled and will receive standard Physician fee schedule rates instead of enhanced EPC rates for services provided on or after July 1, 2026.

Action Required

Before Jul 1, 2026
By June 30, 2026: Billing team must update system settings to use standard Physician fee schedule rates instead of EPC rates for all Nebraska Medicaid claims with service dates on or after July 1, 2026. Update fee schedules in billing software and notify providers that EPC enhanced reimbursement will end. No action needed for claims with service dates through June 30, 2026.