HIV Case Management

HIV Case Management is a client-focused strategy that provides cost-effective, medically necessary services to enhance beneficiary health status and level of functioning.

The goals of HIV case management are to:

  • Improve an eligible beneficiary’s access to a wide range of appropriate services
  • Promote continuity of care by coordinating service delivery arrangements
  • Enhance a beneficiary’s health status and level of functioning
  • Promote efficiency by reducing or containing the overall cost of services

HIV case management is not intended to be an ongoing service. It is a short-term, goal-oriented service tailored to meeting the specific immediate needs of the beneficiary.

HIV case management core components include:

  • Assessment
  • Care planning
  • Resource development
  • Service coordination
  • Monitoring
  • Reassessment
  • Discharge

Fee Schedules

Clinical Coverage Policy 12B

HIV Contact Hours Approval Request Form


Medical Assistance Clinical Section
Phone: 919-855-4340
Fax: 919-715-2372