Bulletins
Post date: 04/05/2019 - 11:11am
Effective for services rendered on or after May 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will no longer reimburse for Current Dental Terminology (CDT) code D2940 (Protective Restoration) as a separate service. Reimbursement rates for restorative services will include the costs of providing temporary or protective fillings as a component of permanent restorative care.
Tags: Dental
Post date: 03/01/2019 - 3:15pm
Effective April 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will amend the Prepayment Claims Review Policy to allow the submission of electronic claims. Unless otherwise specified, claims subject to program integrity prepayment claims review may be submitted electronically. This includes both the claims and the supporting documentation. Providers should carefully review the current manual for compliance with policy guidelines.
Tags: All Providers
Post date: 12/07/2018 - 3:26pm
In January 2019, the South Carolina Department of Health and Human Services (SCDHHS) will begin to enroll opioid treatment programs (OTPs) in the Medicaid provider network and begin to reimburse for medication-assisted treatment (MAT) provided in OTPs. The addition of this benefit will make the full spectrum of pharmacotherapies approved for the treatment of opioid use disorder (OUD) available to Medicaid members. Additional details regarding the enrollment procedures for OTPs will be provided this month.
Tags: All Categories
Post date: 11/09/2018 - 4:25pm
Effective for dates of service on and after Jan. 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will limit reimbursement for moderate sedation or deep sedation/general anesthesia ("sedation services") in dental offices to providers with a sedation permit from the State Board of Dentistry. For sedation services in a dental office to be reimbursed, a valid dental sedation permit must be on file with DentaQuest, and both the authorized office location and administering provider must be clearly documented in the patient's record.
Tags: Dental
Post date: 09/24/2018 - 9:33am
SCDHHS is committed to ensuring reimbursement for services rendered by qualified providers, in good faith, during the Hurricane Florence emergency response period.
Tags: All Providers
Post date: 09/19/2018 - 9:02am
The purpose of this bulletin is to describe additional state efforts to ensure continued access to care during the emergency response to Hurricane Florence and the impact of these efforts on North Carolina Medicaid beneficiaries and South Carolina Healthy Connections Medicaid providers.
Tags: All Providers
Post date: 09/12/2018 - 2:29pm
The purpose of this bulletin is to describe state and federal efforts to ensure continued access to care during the emergency response to Hurricane Florence and the impact of these efforts will have on Healthy Connections Medicaid beneficiaries and providers.
Tags: All Providers
Post date: 08/17/2018 - 3:27pm
Effective Sept. 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will no longer use the SCDHHS Phoenix System or its electronic referral portal, https://phoenix.scdhhs.gov/cltc_referrals/new, for Medicaid targeted case management (MTCM) services or require the Freedom of Choice (FoC) form.
Tags: All Providers
Post date: 06/15/2018 - 4:01pm
Effective with dates of service on and after July 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the applied behavior analysis (ABA) fee schedule and the policy manual for autism spectrum disorder (ASD) services.
Post date: 06/05/2018 - 9:51am
SCDHHS has observed that nearly 16% of recovery claims are rejected by the financially liable insurer for untimely filing. This is due in-part to the length and infrequent commencement of each cycle.
Tags: All Categories
Post date: 06/01/2018 - 4:13pm
Effective July 2, 2018, BlueCross BlueShield of South Carolina (BCBSSC) will perform the following third party liability (TPL) services on behalf of the South Carolina Department of Health and Human Services (SCDHHS):
Tags: All Providers
Post date: 06/01/2018 - 11:25am
Effective with dates of service on or after July 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will limit the billable units of crisis management to 80 units annually, unless otherwise prior authorized by SCDHHS. The daily limits outlined in the respective manuals will remain in place.
Tags: All Categories
Post date: 05/04/2018 - 9:58am
The Improper Payments Information Act of 2002 directs federal agency heads, in accordance with the Office of Management and Budget (OMB) guidance, to review programs on an annual basis that are susceptible to significant erroneous payments and to report the improper payment estimates to Congress. In previous reviews, OMB identified Medicaid and Children's Health Insurance Program (CHIP) as at-risk programs for erroneous payments. As a result, the Centers for Medicare and Medicaid Services (CMS) decided to measure the accuracy of Medicaid and CHIP payments made by states for services rendered to recipients through the Payment Error Rate Measurement (PERM) program.
Tags: All Categories
Post date: 04/04/2018 - 11:22am
Effective May 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) is updating the SCDHHS Dental Periodicity Schedule. This update follows the American Academy of Pediatric Dentistry (AAPD) recommendations on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance and Oral Treatment for Infants, Children and Adolescents. The Dental Periodicity Schedule recommends a set of dental procedures and services that are applicable at each stage of a child's development, from birth through the 21st birthday, with appropriate intervals of care that meet reasonable standards of dental practice.
Tags: Dental
Post date: 03/30/2018 - 2:41pm
To ensure the highest quality care to children enrolled in the South Carolina Medicaid program, the South Carolina Department of Health and Human Services (SCDHHS) adopts the following updates and reminders regarding Early and Periodic Screening, Diagnosis and Treatment (EPSDT) coverage policy. The EPSDT benefit is available to Medicaid beneficiaries under the age of 21.
Tags: All Providers
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