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 N.C. State Health Plan Network is not accepting new providers at this time. The enrollment window closed June 30, 2021. 

The Plan is excited to offer its members copay waivers and reductions for those that visit CPP Providers in 2021. See the chart below for more details. Please note: As part of the CPP copay incentive, the Plan has reduced the copay to $0 if a member visits a CPP behavioral health provider, retroactive to January 1, 2021. See the May 17 Provider Update below.

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;

$10 for other Providers

$0 for CPP Provider;

$30 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.

https://www.shpnc.org/nc-state-health-plan-network