Issued: June 5, 2026
The North Carolina Department of Health and Human Services (NCDHHS) has reversed their decision to discontinue modifiers U1-U6 for Long Term Community Supports (LTCS), effective July 1, 2026. This decision nullifies the May 1, 2026, Provider Alert from Partners Health Management (Partners). This pertains to both NC Medicaid Direct (MD) beneficiaries and Tailored Plan (TP) members.
All code and service definition changes for Tailored Plan LTCS and NC Medicaid Direct LTCS that were scheduled to take effect on July 1, 2026, will not proceed. The impacted codes are listed at the end of this alert for reference.
What do providers need to know?
- When requesting an authorization, providers must select the LTCS Level that matches the member’s person-centered plan (PCP).
- Modifiers will continue to be used for each service level.
- Partners Utilization Management (UM) will be updating and/or extending LTCS authorizations that were ended or approved for the change that was expected on July 1, 2026.
- For service authorization requests (SARS) currently under review, Partners UM will update the authorization request to ensure that the LTCS code matches the level requested.
- The current service definitions for TP LTCS and MD LTCS remain in effect and can be found here: Service Definitions – Partners Health Management – Provider Knowledge Base.
What is changing?
The following LTCS service codes will be reinstated and will not end on June 30, 2026:
- T2016 U5 U1 – Home Living LTCS Level 1
- T2016 U5 U2 – Independent Living LTCS Level 2
- T2016 U5 U3 – Companion Living LTCS Level 3
- T2016 U5 U3 TL – Companion Living LTCS Level 3 Therapeutic Leave
- T2016 U5 U4 – Supervised Living LTCS Level 4
- T2016 U5 U4 TL – Supervised Living LTCS Level 4 Therapeutic Leave
- T2016 U5 U6 – Group Living LTCS Level 5
- T2016 U5 U6 TL – Group Living LTCS Level 5
The following service codes, service descriptions and claim segments are discontinued:
| Service Code | Service Description | Milestone Level |
| T2016 U5 | Level 1 LTCS/LTRDS – Home Living – resides in private home (alone or with family) or in non-Medicaid residential setting with no home/residential support | M1 |
| T2016 U5 | Level 2 LTCS/LTRDS – Independent/ Supported Living – resides in private home (alone or with unpaid roommate) with 24/7 staff access | M2 |
| T2016 U5 | Level 3 LTCS/LTRDS – Companion Living – resides in AFL home or provider owned/operated home with paid roommate, overnight (non-awake) staffing | M3 |
| T2016 U5 | Level 3 LTCS/LTRDS – Companion Living Therapeutic Leave | M3 |
| T2016 U5 | Level 4 LTCS/LTRDS – Supervised Living – resides in three beds or less provider owned/operated setting with 24/7 overnight (non-awake) staff/virtual monitoring | M4 |
| T2016 U5 | Level 4 LTCS/LTRDS – Supervised Living Therapeutic Leave | M4 |
| T2016 U5 | Level 5 LTCS/LTRDS – Group Living – resides in Licensed Group Home (four beds or less) with 24/7 awake-overnight staff/virtual monitoring | M5 |
What do providers need to do?
- Providers should continue submitting claims for each LTCS Level of service as authorized past July 1, 2026.
- Milestones are not required for LTCS services.
- Codes will be changed back in provider contracts so no action is needed from Providers. This task will be completed by June 30, 2026.
Who do I contact if I have questions?
- For authorization related questions: UMQuestions@partnersbhm.org
- For claims related questions: ClaimsDepartment@partnersbhm.org
- For provider related questions: PNRelations@partnersbhm.org