Attendant Care Codes for North Carolina Medicaid
Last week’s NC Medicaid bulletin included updates to procedure codes that home care agencies should be aware of.
As North Carolina Medicaid enters 2026, providers are navigating multiple policy updates, from CPT table corrections to ongoing rate and service-definition changes in long-term services and supports (LTSS).
Attendant Care: Hands-On Assistance with ADLs and Personal Care
In NC Medicaid, “attendant care” is typically delivered and billed as Personal Care Services (PCS) under the State Plan, or In-Home Aide–type services under CAP waivers.
NC Medicaid State Plan – Personal Care Services (PCS)
Core PCS Code
CPT 99509 – Personal care services, per 15 minutes remains the foundational code for PCS statewide.
In-Home PCS Modifiers
For PCS delivered in a participant’s private residence, bill 99509 with HA or HB. These modifiers identify in-home PCS and are most commonly associated with EVV requirements.
PCS in Congregate Settings
PCS delivered in licensed or supervised residential settings still uses 99509, with modifiers identifying the setting type: HC (Adult Care Homes), TT (Combination Homes), SC (Special Care Units), HQ (Family Care Homes), HH/HI (Supervised or supported living facilities).
CAP Waivers: Attendant Care and In-Home Aide Services
Key CAP Attendant Care–Related Codes
- S5125 – In-Home Aide (15-minute units): Primary code for hands-on aide services in the home
- S5125 + UN – In-Home Aide (Congregate Setting): Used in approved congregate or residential environments
- S5150 – Respite, In-Home Aide: Covers aide/attendant-type staffing when delivered as respite
Homemaker Services: Household Help and Environmental Supports
Homemaker / Chore-Specific Codes
- T1020 – Chore Services: Includes cleaning, laundry, decluttering, and similar household support
- S5170 – Meal Preparation and Delivery: Homemaker-adjacent support for members unable to safely prepare meals
Key Takeaways for Providers
- PCS and attendant care are defined by program and setting, not by a single label
- 99509 remains the core PCS code, with modifiers doing the heavy lifting
- CAP waivers provide the clearest structure for attendant care–style services
- Homemaker services are often embedded unless explicitly separated under a waiver
If you need your procedure codes reviewed, schedule a meeting with one of our Agency Strategists to see how we can help.