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What is a cap/C coordinating agency?

The CME is an agency approved by NC Medicaid to act as the CAP/C coordinating agency in a county. The CME shall authorize the rendering of approved HCBS listed in the service plan to selected qualified service providers. The CME is responsible for the day-to-day case management activities for an eligible CAP/C beneficiary.

What is a cap/C place of service code?

Acceptable places for all other CAP/C services to be provided are dependent on service type. The place of service code for a paid live-in caregiver that meets the EVV requirements is code 99. Provider(s) shall bill their usual and customary charges.

Does cap/c Provide Medicaid home and Community-Based Services (HCBS)?

CAP/C is under the 1915(c) waiver to provide Medicaid Home and Community-Based Services (HCBS). It’s authorized by Centers for Medicare & Medicaid Services (CMS) although the state has freedom to request changes. The current waiver was approved starting March 1, 2023 through Feb 29, 2028.

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