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North Carolina to increase direct care worker wages beginning March 1

North Carolina to increase direct care worker wages beginning March 1

Publication Date: February 28, 2022

The North Carolina General Assembly passed legislation through North Carolina Senate Bill 105 to increase hourly wages of direct care workers who provide home and community-based services (HCBS) beginning March 1, 2022. This legislation appropriates funds to begin moving worker wages toward a minimum of $15 per hour during State Fiscal Year 2022, for specific services.

NC Medicaid collaborated with its actuary to determine the definition of HCBS direct care worker within Senate Bill 105. Equitable rate increases were calculated at the procedure code level to fully allocate $210 million in funding. The rate increases are based on a uniform dollar amount per 15-minute unit, adjusted for the amount of service delivered by a direct care worker in each service category. The rate increases are intended to be permanent.

On February 24, 2022, NC Medicaid posted Special Bulletin COVID-19 #230 providing the adjustments calculated for each impacted service reimbursement rate.  The fee schedule increases are included in the Special Bulletin and summarize each of the services impacted by the adjustment. They include selected services within:

Some of the identified services are offered under NC Medicaid’s Local Management Entities-Managed Care Organizations, such as Sandhills Center, and NC Medicaid Direct. For the services Sandhills Center manages, our rate schedule has been updated for each identified code for services provided on and after March 1, 2022.

Sandhills Center’s updated fee schedule can be found at:

Sandhills Center appreciates the work of direct care workers providing the supports necessary for members and families to maximize independent living throughout our communities. We are pleased to pass along these important service reimbursement rate increases to strengthen the direct services provided through these workers, particularly during the challenging environment brought on by the pandemic.