Attention: Private Duty Nursing Providers Verification of School Nursing Form and Instructions Added

The Verification of School Nursing Form – Attachment I (DMA-3171), and Instruction Sheet (DMA-3171-I) were added to the N.C. Medicaid PDN forms web page. The form is used to document Private Duty Nursing (PDN) school hours in accordance with Section 3.4.1, PDN and Schools, of Clinical Coverage Policy 3G-2, Private Duty Nursing for Beneficiaries Under 21 Years of Age.

Home Care Services/Community Based Services

DMA, 919-855-4380