Provider Information

WellCare provides behavioral health benefits to members enrolled in our Medicaid plan. We are committed to quality service and partnership with providers to ensure members get the most of their benefits.

Authorizations

Some behavioral health services may require prior authorization, including services provided by non-participating providers. Obtaining appropriate authorization is essential to providing needed care.

WellCare uses the following:

• North Carolina Behavioral Health Clinical Coverage Policies
• WellCare of North Carolina Clinical Coverage Guidelines
• American Society of Addiction Medicine, Inc. (ASAM): Assesses level of care determinations for substance-related disorders.
• InterQual

Behavioral Health Rates Schedules

• Autism Services (PDF)
• Enhanced Services (PDF)
• Rate Key (PDF)
• Masters Level Rates (PDF)
• MD Rates (PDF)
• NP Rates (PDF)
• Physician Assistant Rates (PDF)
• Psychology Rates (PDF)

Authorization Resources

• Quick Reference Guide (PDF)
• Behavioral Health Authorization List (PDF) 

Trauma Treatment Services for Children and Families

• Enhanced Rates for Trauma Assessments and Treatment Services (PDF)

Contact Us

Providers interested in contracting with WellCare of North Carolina:
Email: ProsProvNC@Wellcare.com
Fax: 1-855-599-3814
Phone: 1-813-865-6503

For any Provider related issues:
Email: NCProviderRelations@Wellcare.com
Phone: 1-984-867-8637
Fax: 1-813-283-3045