North Carolina CAP providers should take action now. NC Medicaid has announced critical enrollment updates that affect Case Managers and Care Coordinators delivering services under the Community Alternatives Program (CAP), including CAP for Children, CAP-Consumer Direction, and CAP for Disabled Adults.
These changes require individual provider enrollment and must be completed by March 1, 2026, to avoid billing delays or service disruptions.
Who Is Affected by North Carolina CAP Enrollment Changes?
These NC Medicaid updates apply to Case Managers and Care Coordinators providing services under:
- Community Alternatives Program (CAP)
- North Carolina CAP – Consumer Direction
- North Carolina CAP for Children
- North Carolina CAP for Disabled Adults
If you work within any North Carolina CAP program, these enrollment changes directly impact you or your organization.
What Changed in North Carolina CAP Medicaid Enrollment?
NC Medicaid clarified that the Case Manager/Care Coordinator taxonomy (171M00000X) is only permitted for individual providers.
What This Means Going Forward
- Individuals must use taxonomy 171M00000X
- Organizations may no longer use taxonomy 171M00000X
- Organizations must instead enroll using taxonomy 251B00000X
NCTracks will enforce this change. Eligibility requirements can be found in the Provider Permission Matrix on the NCTracks Provider Enrollment webpage.
NC Medicaid Announcement:
https://www.nctracks.nc.gov/content/public/providers/provider-communications/2025-Announcements/Important-Updates-for-Case-Manager-Care-Coordinators—Taxonomy-171M00000X.html
NCTracks Portal:
https://www.nctracks.nc.gov/content/public
What Individual Case Managers and Care Coordinators Must Do
If you provide services under North Carolina CAP, you must be enrolled as an individual provider in NCTracks.
Required Steps for Individual Providers
- Obtain an Individual NPI
Apply through the National Plan and Provider Enumeration System (NPPES) if you don’t already have one.
- Enroll in NCTracks as an Individual Provider
Use taxonomy 171M00000X during enrollment.
- Affiliate with Your Organization’s Billing NPI
This allows your employer or agency to bill for services you provide.
- You can affiliate during enrollment or
- Submit a Manage Change Request later in NCTracks
Failure to complete these steps could result in interrupted billing or denied claims for North Carolina CAP services.
What Organizations Providing North Carolina CAP Services Must Do
Organizations currently enrolled using taxonomy 171M00000X must update their enrollment records to remain compliant.
Required Actions for Organizations
- Remove taxonomy 171M00000X
- Add taxonomy 251B00000X
- Submit changes via a Manage Change Request in NCTracks
These updates are mandatory for organizations supporting North Carolina CAP Case Management and Care Coordination services.
Deadline to Stay Compliant with North Carolina CAP Medicaid
All enrollment updates must be completed by March 1, 2026
Missing this deadline may lead to:
- Billing disruptions
- Delayed reimbursements
- Service interruptions for North Carolina CAP participants
Need Help Navigating North Carolina CAP Enrollment Changes?
If you have questions about North Carolina CAP Medicaid enrollment, individual NPIs, or NCTracks change requests, our GEOH agency specialists are here to help.
If you have any questions or concerns, please contact one of our specialists today!
