Personal Care Services

About Our Services

For eligible Medicaid beneficiaries, Personal Care Services (PCS) provides hands-on assistance, by paraprofessional aides, for the five qualifying activities of daily living (ADLs) which include eating, dressing, bathing, toileting, and mobility.

The amount of approved service is based on an assessment conducted by an independent assessment entity to determine the beneficiary’s ability to perform their ADLs.

PCS provides support to individuals residing in a:

Private living arrangement
Residential facility licensed by North Carolina as an adult care home
Combination home as defined in G.S. 131E-101(1a)
Group home licensed under Chapter 122C of the General Statutes and under 10A NCAC 27G.5601 as a supervised living facility for two or more adults whose primary diagnosis is mental illness, a developmental disability or substance abuse dependency

Three of the five ADLs with limited hands-on assistance
Two ADLs, one of which requires assistance at the full dependence level

PCS program eligibility is determined by an independent assessment conducted by NC Medicaid or its designee, and is provided according to an individualized service plan.

To be considered, the individual’s primary care or attending physician, physician assistant, or nurse practitioner must make the referral for the individual to be assessed for PCS using the Request for Independent Assessment for Personal Care Services Attestation of Medical Need Form (Form 3051). Acentra will review the form and schedule an assessment.

Learn more at DHHS

Personal Care Services Realignment Launch

4/08/25

Please see the Medicaid Bulletin referencing the PCS Realignment Launch!

Personal Care Services Rate Reimbursement Methodology for Individuals Living in Congregate Settings

3/21/25

On April 1, 2025, NCTracks will adjudicate PCS claims for 99509 SC, 99509 HC, 99509 TT, 99509 HH, 99509 HI, 99509 HQ using a per diem billing methodology to comply with NC Medicaid Clinical Coverage Policy (CCP) 3L-1. A Medicaid Bulletin was posted...

2025 PCS Front Porch Chats

1/03/25

The 2025 PCS Front Porch Chat schedule is listed below for individuals participating in the Personal Care Services program. Use the links below to register. February 2/20/2025 Change of Status Process, Mediation & Appeals, IADL's vs ADL's - Register here! May...

DHB 3051 Transition

12/16/24

Beginning April 1, 2025, processing requests for PCS using the old version of the DHB3051 form will be delayed while the provider corrects the request by using the current version of the DHB 3051, Request for Services and Instructions (DHB 3051).

PCS Rate Methodology Change Effective Jan. 1, 2025

12/03/24

Two policies will be effective on Jan. 1, 2025, and posted to the NC Medicaid website. Click here to learn more! Effective Jan. 1, 2025, the unit of reimbursement will change from a 15-minute increment to a daily per diem. Click here...

Tailored Plan (TP) Launch and PCS

6/28/24

Announcement Starting July 1, 2024, NC Medicaid members with serious mental health or substance issues, an intellectual/developmental disability, or a traumatic brain injury will transition their Medicaid coverage to a Tailored Plan (TP). In April, the NC Medicaid Enrollment Broker...

VieBridge Extending Beneficiary PAs

1/03/24

The following are the steps taken each month for extending PAs for beneficiaries whose annual assessment is delayed beyond their one year anniversary. At the end of each month, the system check for beneficiaries who have not had an annual...

Dedicated to high-quality care and an efficient healthcare experience

At a Glance

Covered Personal Care Services include

Services not approved under Personal Care Services (PCS) include: