N.C. State Health Plan Network
The State Health Plan (Plan) would like to extend its sincere gratitude to the organizations that continue to support the Clear Pricing Project (CPP) by being a part of the N.C. State Health Plan Network. The main goal of the Clear Pricing Project is to provide a fair and transparent network for our members while preserving and protecting the Plan’s financial sustainability.
The State Health Plan will not be accepting new providers to join the NC State Health Plan Network as a Clear Pricing Project Provider for the 2024 benefit year, which begins Jan. 1, 2024. This means there will not be a window of opportunity to join available in 2023. The State Health Plan will be centrally focused on its transition to Aetna, its new third-party administrator effective Jan. 1, 2025. More information regarding the NC State Health Plan Network for 2025 will be forthcoming. Thank you for your continued interest in providing care to State Health Plan members who teach, protect, and serve.
The Plan is excited to offer its members copay waivers and reductions for those that visit CPP Providers in 2022. The copays below will also be in place for the 2023 benefit year.
Clear Pricing Project Provider Member Copay Comparison Chart |
||
---|---|---|
Provider |
80/20 Plan |
70/30 Plan |
Primary Care Provider (PCP) |
$0 for Clear Pricing Project (CPP) PCP on ID card; $10 for non-CPP PCP on ID card; $25 for any other PCP |
$0 for Clear Pricing Project (CPP) PCP on ID card; $30 for non-CPP PCP on ID card; $45 for any other PCP |
Behavioral Health Provider |
$0 for CPP Provider; $25 for other Providers |
$0 for CPP Provider; $45 for other Providers |
Specialist |
$40 for CPP Specialist; $80 for other Specialists |
$47 for CPP Specialist; $94 for other Specialists |
Speech, Occupational, Chiropractor and Physical Therapy |
$26 for CPP Providers; $52 for other Providers |
$36 for CPP Providers; $72 for other Providers |
For questions regarding your contract, please call Blue Cross NC Network Management line at 800-777-1643, and select Option 6. All other questions can be sent via email to SHPProviderNetwork@nctreasurer.com.
Provider Resources
- 2023 NCSHP Network Participation Agreement
- 2022 NCSHP Network Participation Agreement
- 2021 NCSHP Network Participation Agreement
- 2020 NCSHP Network Participation Agreement
- NCSHP Network Master Reimbursement Exhibit
- Professional Pricing Policy
- SHP Pricing Policy
- SHP Professional Fee Schedule
- SHP Membership by County
- BlueCross NC Provider Portal