MEDICAID PCS CLIENTS

PCS Eligibility and Application

To qualify for PCS, an individual must have a medical condition, disability
or cognitive impairment, and demonstrates unmet needs for:

• Three of the five ADLs with limited hands-on assistance
• Two ADLs, one of which requires assistance at the full dependence level

PCS program eligibility is determined by an independent assessment conducted by NC Medicaid or its designee, and is provided according to an individualized service plan.

To be considered, the individual’s primary care or attending physician, physician assistant, or nurse practitioner must make the referral for the individual to be assessed for PCS using the Request for Independent Assessment for Personal Care Services Attestation of Medical Need Form (Form 3051).

The state will do an assessment and the patient is given a list of all the agencies in town.

https://medicaid.ncdhhs.gov/request-services-and-instructions-dhb-3051/download?attachment

MEDICAID PATIENTS CAN FILL OUT A DMA 3051 AND Fax NC LIFTSS PCS at 833-521-2626 (toll free).

Expedited Assessment Process Info: Contact NC LIFTSS at 1-833-522-5429.

Questions: Call NC LIFTSS at 1-833-522-5429.