North Carolina has a PPEC program under Medicaid, but finding a center can be challenging. The state has far fewer licensed facilities than larger programs like Florida's. If you are a parent of a medically complex child in NC, this guide covers what PPEC is, who qualifies, how to locate a center, and what alternatives exist if there is not one near you.
Key Takeaways
- PPEC (Prescribed Pediatric Extended Care) is a licensed medical daycare program that provides skilled nursing, therapy, and developmental activities for children with complex health needs.
- North Carolina covers PPEC through Medicaid for children from birth through age 20.
- The number of licensed PPEC centers in NC is limited compared to states like Florida, which has dozens of active facilities.
- Families can search for providers through the NC Medicaid Find a Doctor tool or call the NC Medicaid Provider Ombudsman at 1-866-304-7062.
- If no PPEC center is available near you, alternatives include private duty nursing, HCBS waivers, and the CAP/C program.
What Is PPEC?
PPEC stands for Prescribed Pediatric Extended Care. It is a licensed, non-residential medical daycare where children with complex medical conditions receive skilled nursing care, therapy, and developmental support during the day.
Your child gets the medical attention they need while also playing, learning, and spending time with other kids. It combines the safety of clinical care with the warmth of a real childhood. Learn more about why families choose medical daycare.
PPEC centers typically provide:
- Skilled nursing care: Medication administration, trach care, G-tube feedings, ventilator management, and seizure monitoring
- Therapy services: Physical therapy, occupational therapy, speech therapy, and feeding therapy
- Developmental activities: Age-appropriate learning, sensory play, and socialization
- Caregiver training: Hands-on support so you feel confident managing care at home
- Nutrition support: Meal plans and feeding programs tailored to each child's needs
In every state that offers PPEC, services are covered by Medicaid at no cost to families. No copays. No deductibles. See how Medicaid covers PPEC at zero cost.
How PPEC Works in North Carolina
North Carolina includes PPEC as a benefit under its Medicaid program. Children from birth through age 20 with qualifying medical conditions can receive services at licensed PPEC centers across the state.
Here is what NC families need to know:
The biggest challenge in North Carolina is availability. Unlike Florida, which has dozens of licensed PPEC centers spread across the state, North Carolina has a much smaller network of providers. Depending on where you live, the nearest center may be a significant drive away, or there may not be one in your area at all.
That does not mean your child cannot get care. It means you may need to explore multiple options, and we will cover those below.
Who Qualifies for PPEC in North Carolina?
Your child may be eligible for PPEC services in North Carolina if they meet these general criteria:
- Enrolled in NC Medicaid. Your child must have active Medicaid coverage in North Carolina. Only the child's income and resources are counted for eligibility, not the family's.
- Under 21 years old. The program serves children from birth through age 20.
- Medically complex condition. Your child must have a chronic medical condition that requires skilled nursing care or ongoing medical interventions.
- Physician prescription. A doctor must prescribe PPEC services and document medical necessity.
- Prior authorization. NC Medicaid or your child's managed care plan must authorize the services before they begin.
If you are unsure whether your child qualifies, the best first step is talking to their pediatrician. You can also call the NC Medicaid Provider Ombudsman at 1-866-304-7062 for guidance on eligibility and enrollment.
Learn more about PPEC eligibility requirements.
How to Find a PPEC Center in North Carolina
Because the number of licensed PPEC providers in NC is small, finding a center takes a bit more effort than in states with larger programs. Here is how to search:
- NC Medicaid Find a Doctor tool. Visit medicaid.ncdhhs.gov/find-doctor and search for PPEC or pediatric extended care providers in your area. This is the most up-to-date source for enrolled Medicaid providers.
- Call the NC Medicaid Provider Ombudsman. Dial 1-866-304-7062. The ombudsman can help you locate providers, understand your coverage, and navigate the enrollment process.
- NC Medicaid Provider Information page. Visit medicaid.ncdhhs.gov/providers for provider manuals, enrollment details, and program policies.
- Ask your child's care team. Pediatricians, case managers, and hospital social workers often know which PPEC centers are active in your region and accepting new patients.
- Contact community organizations. Groups like Amazing Kids of NC serve medically fragile children across central and eastern North Carolina. While not a PPEC center, they provide case management, in-home nursing, and respite care through the CAP/C (Community Alternatives Program for Children) waiver.
If you cannot find a PPEC center in your area, do not give up. The next section covers alternative programs that can help your family.
Alternatives If No PPEC Center Is Nearby
Many North Carolina families live in areas without a nearby PPEC provider. These programs can fill the gap:
CAP/C (Community Alternatives Program for Children)
North Carolina's CAP/C waiver provides home and community-based services for medically fragile children under 21 who would otherwise need nursing facility care. Services include in-home nursing, respite care, medical equipment, home modifications, and caregiver training. Organizations like Amazing Kids of NC provide CAP/C case management in Durham, Wake, Johnston, Nash, and surrounding counties.
Private Duty Nursing (PDN)
Available through NC Medicaid, private duty nursing brings a registered nurse or LPN to your home to provide skilled care for your child. It does not offer the socialization or therapy that PPEC provides, but it does give your child one-on-one medical attention. See how PPEC compares to private nursing.
Early Intervention (NC Infant-Toddler Program)
For children under 3, North Carolina's Infant-Toddler Program provides developmental therapy and support services regardless of PPEC availability. Contact the NC Early Intervention Branch to learn more.
Katie Beckett / Health Choice for Children
North Carolina offers Medicaid pathways that qualify children based on the child's medical condition rather than family income. If your child has significant medical needs but your household income is too high for traditional Medicaid, ask your county DSS office about these options.
Frequently Asked Questions
Does North Carolina have PPEC?
Yes. North Carolina has a PPEC program covered by Medicaid for children from birth through age 20. However, the number of licensed PPEC centers in the state is limited compared to states with larger programs like Florida or Texas.
How much does PPEC cost in North Carolina?
PPEC is covered by NC Medicaid at no cost to eligible families. There are no copays, deductibles, or out-of-pocket expenses. Your child must be enrolled in Medicaid and have a qualifying medical condition.
How do I find a PPEC center near me in NC?
Start with the NC Medicaid Find a Doctor tool online. You can also call the NC Medicaid Provider Ombudsman at 1-866-304-7062 for help locating a provider in your area.
What if there is no PPEC center in my part of North Carolina?
If no PPEC center is available nearby, look into the CAP/C waiver program, private duty nursing through Medicaid, and the NC Infant-Toddler Program (for children under 3). Your child's pediatrician or hospital social worker can help connect you to local resources.
What ages does PPEC cover in North Carolina?
NC Medicaid covers PPEC services for children from birth through age 20. A physician must prescribe the services and document medical necessity.
What conditions qualify for PPEC?
Children with a wide range of complex medical conditions may qualify, including cerebral palsy, tracheostomy, ventilator dependence, seizure disorders, G-tube dependency, respiratory failure, and many others. See all conditions commonly served at PPEC centers.
Getting Your Child the Right Care
Finding care for a medically complex child in North Carolina takes persistence, especially with limited PPEC availability. But the options are real, and you do not have to figure it out alone.
Start by calling the NC Medicaid Provider Ombudsman at 1-866-304-7062. They can help you find PPEC providers, understand your child's coverage, and connect you with alternative programs if no center is nearby.
If you are in Florida or Texas, Spark Pediatrics operates 15+ centers with experienced NICU and PICU nurses, integrated therapy, and a warm environment where your child can thrive. Check if your child qualifies or get started today.
For a complete list of states with PPEC programs, see our PPECs by State guide.
This article was reviewed for accuracy as of March 2026. PPEC regulations and provider availability change as states update their Medicaid programs. Always verify current eligibility and provider information with your state Medicaid office or a licensed PPEC provider.
Spark Pediatrics is Florida's largest PPEC provider and operates PPECC centers in Texas. View all locations | Learn about our services | Get started today