MedicaidDocumentationHigh impact
Updated 1915(i) Assessment and Companion Guide Now Available
NC Medicaid - NCDHHS·NC·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Aug 11, 2026
Summary
NC Medicaid has released an updated 1915(i) Assessment Tool with new fields capturing more detailed beneficiary information, effective October 1, 2026. The revised tool must be used for all new 1915(i) service requests and eligibility reassessments; previous versions published before August 3, 2026 will be rejected and returned as 'Unable to Process.' A companion guide has been created to support implementation.
Action Required
By October 1, 2026: Billing and clinical teams must transition all 1915(i) assessment documentation to the revised NC Medicaid 1915(i) Assessment Tool. (1) Download the updated assessment tool and Companion Guide from NC Medicaid's website. (2) Update intake and reassessment workflows to require the new form for all beneficiaries requesting 1915(i) services and all existing beneficiaries undergoing eligibility reassessment. (3) Train clinical staff, care coordinators, and billing personnel on the new fields and documentation requirements using the Companion Guide. (4) Update templates in EHR/billing systems to reflect the revised assessment format. (5) Audit any assessments in progress to ensure compliance before the effective date. Failure to use the updated tool will result in claims being returned marked 'Unable to Process' and delayed service authorizations. Contact NC Medicaid Contact Center at 888-245-0179 for technical support or clarification.