N.C. State Health Plan Network

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State Health Plan Network Information for Providers

This page includes provider information regarding the NC 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. Thank you for your continued interest in providing care to State Health Plan members who teach, protect, and serve.

The State Health Plan will transition to Aetna, its new third-party administrator effective Jan. 1, 2025. As such, providers will need to be in-network with Aetna in 2025 in order to see State Health Plan members on an in-network basis. Additional information is posted on this page. 

Interested providers can go ahead and join their network by visiting their website.

ALL current CPP providers will need to take action and re-sign up to remain a CPP provider when the State Health Plan transitions to Aetna. Click here to start that process. You only join CPP once for your TIN. All providers practicing under that TIN will be part of CPP.

*This is the 2024 fee schedule, which will be updated in May of 2025 as it is dependent on CMS. 

The Plan continues to offer its members copay waivers and reductions for those that visit CPP Providers. The copays below will also be in place for the 2025 benefit year.

Provider Resources (Aetna)

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 current contract with Blue Cross NC, please call Network Management line at 800-214-4844, and select Option 6. If you have questions regarding your contract with Aetna or questions about your application, please call Aetna's Provider line at 888-632-3862.

All other questions can be sent via email to SHPProviderNetwork@nctreasurer.com.

Provider Resources (Blue Cross NC)