What is NC Medicaid Direct?
NC Medicaid Direct is North Carolina’s current health care program for Medicaid beneficiaries who are not enrolled in NC Medicaid Managed Care. NC Medicaid Direct includes care coordination from:
- Community Care of North Carolina (CCNC), the primary care case management entity (PCCMe)
- Six regional Local Management Entity-Managed Care Organizations (LME-MCOs)
- LME-MCOs coordinate services for a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI).
Most people who have behavioral health, substance use, intellectual and developmental disability (I/DD) or traumatic brain injury (TBI) support needs will keep getting their Medicaid services through NC Medicaid Direct. They will get their health and pharmacy services from the State and behavioral health services from the State or a Local Management Entity-Managed Care Organization (LME-MCO). Most people who get services from an LME-MCO will stay enrolled in NC Medicaid Direct.
To learn more about behavioral health, I/DD or TBI support needs, go to medicaid.ncdhhs.gov/providers/programs-services/mental-health/behavioral-health-services.
To learn more about NC Medicaid Direct, call the NC Medicaid Contact Center at 1-888-245-0179.
NC Medicaid Direct behavioral health, I/DD and TBI services
NC Medicaid Direct offers added services not available through NC Medicaid Managed Care, including:
- Residential treatment facility services for children and adolescents
- Child and adolescent day treatment services
- Intensive in-home services
- Multi-systemic therapy services
- Psychiatric residential treatment facilities
- Assertive community treatment
- Community support team
- Psychosocial rehabilitation
- Substance abuse non-medical community residential treatment
- Substance abuse medically monitored residential treatment
- Intermediate care facilities for individuals with intellectual disabilities (ICF/IID)
- Substance Abuse Comprehensive Outpatient Treatments (SACOT)
- Substance Abuse Intensive Outpatient Treatment (SAIOT)
- Innovations waiver services
- TBI waiver services (only available in counties served by the LME-MCO Alliance Health)
- 1915(b)(3) services
For a full list of services that all health plans offer, go to Benefits and services.
How to get services for behavioral health, I/DD and TBI support needs
Until 2022, you can get services for behavioral health, I/DD and TBI support needs from an LME-MCO. To get these services, you must stay in NC Medicaid Direct or the Eastern Band of Cherokee Indians (EBCI) Tribal Option. As a member of the EBCI Tribal Option, you can still get services from any Medicaid or NC Health Choice provider.
If you enroll in NC Medicaid Managed Care, you may not be able to get your behavioral health, I/DD or TBI services. NC Medicaid Managed Care does not include many of the services that LME-MCOs offer.
You can find your LME-MCO at ncdhhs.gov/providers/lme-mco-directory. To learn more about how to get services for behavioral health, I/DD and TBI support needs, contact your LME-MCO or call us at 1-833-870-5500 (TTY: 711 or RelayNC.com). The call is toll free. Or use the chat tool to chat with us online.