Rate and Checkwrite Schedules

All network providers are reimbursed at the lesser of the Vaya Health published rates for the service being provided or your usual and customary charge for the services, unless otherwise stated in your contract or identified in the Provider Portal. In general, Vaya follows the NC Medicaid fee schedule for Medicaid services.

Rate changes will be announced at least 30 days in advance unless they result from a change imposed by the General Assembly, NC Medicaid or the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS). You can submit claims for more than the published rates, but only the published or contracted
rate will be paid.

If you submit a claim for less than the published or contracted rate, the lower rate will be paid. It is the provider’s responsibility to monitor the publishing of rates and to make the necessary changes to their billing systems.

Current Rate Schedules

Archived Rate Schedules

Rate Schedules Effective 07/01/2022 to 11/30/2022

Checkwrite Schedule

Vaya adheres to the standardized LME/MCO checkwrite schedule, which is based on a 5 p.m. Tuesday cutoff. Claims received before this cutoff date will be paid the following week according to the checkwrite schedule. The schedule  accommodates for state and federal holidays occurring during the work week. 

Vaya Health 2022 Checkwrite Schedule

Vaya Health 2023 Checkwrite Schedule