NC AHEC Practice Support is celebrating 20 years
(2006-2026)
Established in 1972 to address healthcare workforce shortages, NC AHEC Practice Support has evolved from focusing on medical training to providing tailored, on-the-ground, and virtual coaching for primary care, behavioral health, and specialty practices across all 100 North Carolina counties, aiding over 1,300 practices with health IT, quality improvement, and Medicaid transformation. Thank you for 20 years of making a difference in the lives of others in North Carolina.
Register Now! Practice Manager Basic Courses
Practice Manager Basic Courses
September 7, 2026 – May 10, 2027
Location: Zoom
Target Audience
Novice practice managers, experienced practice managers, providers and staff who desire an overview of the basics of medical practice management.
Program Description
The Practice Manager Basic Courses include ten separate courses that introduce the basic concepts of practice management: financial management, insurance, the revenue cycle, coding, human resources, customer service, leadership, operations management, and quality improvement.
A new one-hour recorded lesson is released each Monday during the course. To receive a completion certificate, all quizzes must be completed by midnight on the final day of the course. The Practice Management Academy’s free mobile app makes it easy for you to learn any time or any place that works for you. COURSES MAY BE TAKEN INDIVIDUALLY OR COMPLETED IN THEIR ENTIRETY AT A DISCOUNTED RATE of $900 compared to the total price of $1080. To register for the entire course module, please contact Christi Boahn at 910-678-7240 or email at christi.boahn@sr-ahec.org
Updates
NC Medicaid: Major eligibility changes begin October 1
October 1, 2026 is the effective date for new NC Medicaid eligibility restrictions affecting many non-U.S. citizens. NC Medicaid says some beneficiaries who are not U.S. citizens may lose coverage unless they fall into specified categories, including certain lawful permanent residents, lawfully residing children, pregnant/postpartum individuals, Cuban/Haitian entrants, and citizens of certain Compact of Free Association nations.
A separate major change is coming January 1, 2027 for many adults ages 19–64: an 80-hour-per-month work, school, volunteering, or income requirement, along with six-month Medicaid renewals.
Practices should train staff to:
1. Verify Medicaid eligibility at appropriate points in the workflow.
2. Encourage patients to maintain current addresses and contact information with DSS.
3. Direct patients to respond promptly to DSS notices.
4. Help patients understand how to use enhanced ePASS when documentation is required.
5. Establish a workflow for patients whose Medicaid eligibility changes.
6. Identify community resources for patients who become uninsured.
RHC/FQHC telehealth: October 1, 2026, is a workflow/billing transition point
Beginning October 1, 2026, RHCs and FQHCs will move away from using G2025 for distant-site telehealth and instead report the applicable CPT/HCPCS telehealth service code with the appropriate modifier, such as:
• 93 – synchronous audio-only
• 95 – synchronous audio/video
CMS says the payment methodology will continue to use the average amount for PFS telehealth services.
ICD-10-CM: 2027 code set is effective October 1
The October 1, 2026, procedure code update files are now available. Use these codes for discharges occurring from Oct. 1, 2026, to Sept. 30, 2027, and for patient encounters occurring from Oct. 1, 2026, to Sept. 30, 2027.
Providers can access the list of ICD-10 codes on the CMS ICD-10 webpage.
ICD-10-CM Codes
• Click on “2027 Code Description in Tabular Order [ZIP]”
• Select the file titled “order_addenda_2027.txt”
ICD-10-PCS Codes
• Click on “2027 ICD-10-PCS Order File (Long and Abbreviated Titles) [ZIP]”
• Select the file titled “order_addenda_2027.txt”
Controlled substances: NCTracks/DEA certification deadline is November 1, 2026
NC Medicaid announced that beginning November 1, 2026, pharmacy claims for controlled substances will be denied if the prescriber does not have an active DEA certification on their NCTracks provider enrollment record.
Practices should:
1. Identify providers who prescribe controlled substances.
2. Verify DEA information.
3. Confirm the information is active/correct in NCTracks.
4. Address discrepancies before November 1.
5. Build this into provider onboarding/offboarding workflows.
NC Medicaid Managed Care: AMH and value-based care remain major practice priorities
NC Medicaid continues to evolve the Advanced Medical Home (AMH) model as the primary vehicle for local care management. The latest AMH Provider Manual was released July 28, 2026.
NC Medicaid also established an $11.34 PMPM care-management assumption for SFY 2027 within Standard Plan capitation rates. Importantly, NC Medicaid states this is an expected average cost—not a minimum required payment—and practices and PHPs are expected to negotiate rates based on the intensity and breadth of care management.
NC Medicaid PHP/network management: Provider-directory accuracy is becoming an operational issue
NC Medicaid launched a Provider Directory API in 2026 that provides electronic access to provider-directory information across NC Medicaid Managed Care and NC Medicaid Direct. The information originates from NCTracks and is supplemented with health-plan contract information.
NC Medicaid is encouraging providers to review their NCTracks information and submit updates through the Managed Change Request process.
NC Medicaid quality measurement: Move from “reporting” to data-driven QI
NC Medicaid released its MY2026 Medicaid Managed Care Quality Measurement Technical Specifications Manual on June 11, 2026.
The state continues to use quality measures to evaluate PHP performance and AMH performance, while emphasizing outcomes, health disparities, and continuous quality improvement.
Recent NC Medicaid Quality Fact Sheets include areas such as:
• Access to care
• Cancer screening
• Pediatric/adolescent dental care
• Primary care for children
• Immunizations
• Behavioral/mental health
• Tobacco/substance use
• Racial disparities in vaccination
Medicare ACOs: 2027 brings another major transition
CMS’s new LEAD (Long-term Enhanced ACO Design) Model launches January 1, 2027, following the conclusion of ACO REACH at the end of 2026. LEAD is designed as a 10-year voluntary model and specifically includes smaller, independent, and rural practices among the types of providers CMS is seeking to support.
For practices affiliated with an ACO, 2027 could bring changes in:
• Attribution
• Benchmarking
• Quality reporting
• Care-management expectations
• Data sharing
• Risk arrangements
• Population health workflows
PODCAST: What if it’s me? A manager’s response to turnover
Your best employees keep walking out the door. Maybe it’s time to take a painful look in the mirror and consider if your management style may be contributing to the problem. GeGe Beall of Engaged At Work discusses this uncomfortable issue and how you can face it and transform your practice into a place employees enjoy.
Find out more about GeGe at engagedatwork.com.
For information about the North Carolina Practice Management Academy, visit ncahecpma.org
Continuing Professional Development
In-Person | Live Webinar
Looking to grow your skills or stay ahead of regulatory changes? SR-AHEC Continuing Professional Development offers a variety of courses through in-person sessions and live webinars. Our trainings are practical, timely, and tailored to today’s healthcare environment.
Explore upcoming opportunities and register today!
Click here to see our full course catalog
We have a new web address for the Practice Management Academy
ncahecpma.org – Go check it out!
Any bookmark you have should still work because we’ve mapped the old URL to the new one. If you’d like to see what our new page looks like, you may need to sign out of the academy so you can see the landing page. Anyone can join the free side of the Practice Management Academy. This includes any free courses, access to our group chat, and announcements about upcoming classes and events. We hope this new address and page will be easier to navigate and share.
