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NC Integrated Care for Kids Closeout and Related Billing Code Changes
Effective date
Dec 31, 2026
Identified
Jul 10, 2026
Summary
NC Medicaid is closing the NC Integrated Care for Kids (InCK) pilot program effective December 2026. Two food/housing screening G codes (G9919, G9920) will be rejected after December 31, 2026, while the Kindergarten Readiness Promotion Bundle code (CPT 1003F with modifiers SE, TS) will continue indefinitely for well-child visits in children ages birth to 6. Billing teams must stop using the discontinued G codes and ensure proper use of CPT 1003F with appropriate modifiers to document bundle completion.
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What to do
Action · 7 steps
01REQUIREMENTS:
By December 31, 2026: Billing team must stop submitting claims with G codes G9919 and G9920 for NC Medicaid (Direct and Standard Plans).
02Remove these codes from all billing templates, encounter forms, and billing system workflows.
03Claims containing G9919 or G9920 submitted after December 31, 2026, will be rejected.
04Immediately (effective now): Billing team must update billing software and provider education materials to properly document CPT 1003F usage for well-child visits (ages birth to 6) using the following modifier combinations:
- CPT 1003F (no modifier) = bundle received without Pre-K referral or office-based literacy promotion
- CPT 1003F + modifier SE = bundle includes office-based literacy promotion
- CPT 1003F + modifier TS = bundle includes Pre-K referral
- CPT 1003F + modifier SE and TS = bundle includes both office-based literacy promotion and Pre-K referral
Providers must document that at least five of the eleven bundle components were completed (well visit, hearing/vision screening, developmental screening, social-emotional screening, office-based literacy promotion, fluoride varnish, Pre-K referral, Exceptional Children's program referral, parenting support, early childhood mental health referral, or community-based literacy program referral).
05Note: G9921 has already been end-dated (removed December 31, 2024) and no action is needed.
06Consequences: Claims with G9919 or G9920 submitted after the deadline will be denied.
07Incorrect or missing modifiers on CPT 1003F may result in claim denials or delays.
Codes mentioned
G9919G9920G9921
Original notice
NC Integrated Care for Kids Closeout and Related Billing Code Changes
medicaid.ncdhhs.gov · Always check the source before changing claims.