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NC Department of Health and Human Services
NC Division of
Medical Assistance

Personal Care Services-Plus

Program was terminated May 31, 2011

DMA Clinical Policy and Programs
Phone Number 919-855-4360
Fax 919-715-2628

Personal Care Services-Plus (PCS-Plus) is an enhancement to the Personal Care Services (PCS) program.  PCS-Plus is for recipients who have a qualifying medical condition and personal care needs that exceed the service limit for PCS.  Services include assistance with personal care tasks such as bathing, toileting, ambulating, and monitoring vital signs.  In addition, services such as housekeeping and home management tasks may be provided if they are essential to the personal care task(s) necessary for maintaining the recipient’s health.

Independent assessment of personal care services (PCS) recipients was implemented on April 1, 2010. DMA has contracted with the Carolinas Center for Medical Excellence (CCME) External link to conduct the assessments.

Additional information is available on the PCS Independent Assessment website External link. Questions may be directed to the CCME Independent Assessment Help Line at 1-800-228-3365 or by e-mail to

For service requirements, coverage criteria and limitations, refer to Clinical Coverage Policy #3C, Personal Care Services and PCS-Plus.(Terminated 5/31/11)

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.

PCS Forms

Refer to CCME's Independent Assessment website External link for referral forms and instructions for requesting change of status reviews.

To see forms that apply to all providers, please visit our Provider Forms page.

Effective October 1, 2013, all PCS referral/request forms were consolidated into the DMA 3051 Personal Care Services (PCS) Request for Services Form. With the implementation of DMA 3051, the following forms are no longer used:

  • DMA 3041 New Referral Request Form - Home Care Agency
  • DMA 3068 New Referral Request Form - Licensed Residential Facility
  • DMA 3042 Change of Status Request Form - Home Care Agency
  • DMA 3069 Change of Status Request Form - Licensed Residential Facility
  • DMA 3043 Change of Provider Request Form - Home Care Agency
  • DMA 3070 Change of Provider Request Form - Licensed Residential Facility

Below are all the currently used Personal Care Services forms: Ready NC Connect NC