CareSource North Carolina's bonus to a provider for each HbA1c result reported on a claim as a CPT II result code, for marketplace members with diabetes (any result band pays the same)
$15.00
USD per HbA1c test result reported (paid to the provider, up to 4 a year per patient), US (North Carolina)
“CareSource North Carolina Co. is offering bonus payments to providers for submitting A1C CPT-II Codes on claims. ... 3044F Most recent A1C <7.0% 3046F Most recent A1C >9.0% 3051F Most recent A1C >7.0% & < 8.0% 3052F Most recent A1C > 8.0% & < 9.0% $15.00 Payable 4 times per calendar year per patient ... Perform the recommended A1C test according to the current clinical guidelines for eligible CareSource North Carolina Co. members who are 18+ years old with a diagnosis of diabetes (Type 1 or 2).”
- Kind of source
- The payer's or seller's own page
- Read on
- 2026-11-07
- Daily check
- Quote found at the source on 2026-11-07
- What to know
- A health plan's published price for one lab value, paid to the treating practice (not the patient) on top of the test's own fee, whatever the result, for reporting the HbA1c band on the claim so the plan can measure diabetes care (HEDIS) without a chart review. It buys a coded result band for the plan's own quality use and includes the practice's coding work, so it is not a research licence; CareSource's West Virginia notice of July 2024 pays the same $15.00.
- Arithmetic
- Stated per result; no arithmetic. At most 4 x $15.00 = $60 a year per patient. Filed as side cost by the operator: a health plan paying a practice to code and report one result for its own quality measurement is what it costs that buyer to obtain the result, not a research licence price.
Used in
Kept as evidence; no figure on the platform is computed from it yet.