|
Vaya Health has updated our rate schedules for certain Medicaid behavioral health, I/DD, and TBI services effective Oct. 1, 2025, to maintain consistency with NC Medicaid fee schedule changes communicated in last week’s NC Medicaid Bulletin and Vaya Provider Communication Bulletin 2025-26 Issue 16. The new rates are available on the Rate and Checkwrite Schedules page of our Provider Central website.
Vaya plans to implement the rate schedule changes no earlier than Nov. 1, 2025. If there is no state legislative agreement by Oct. 31, Vaya will implement the rate cuts on Nov. 1, retroactive to the effective date of Oct. 1. On that date, we plan to update our systems to pay at the newly published Vaya rates, and we will take steps to recoup the difference in reimbursement for services provided back to Oct. 1.
Providers should know NCDHHS is reducing the capitation rates of Vaya and the other managed care plans effective Oct. 1 which will impact funding for these services, and we do not have any funding or flexibility to postpone the cuts indefinitely unless action is taken at the state level to reverse the Department’s decision to implement provider rate reductions. For more information, refer to the North Carolina Association of Public Community Health Plans’ letter to the provider community.
If you have questions, please email provider.info@vayahealth.com or join Vaya’s Provider Touchpoint webinar from 11 a.m.-12 p.m. Oct. 3, 2025.
| 
