Bulletins
Post date: 08/28/2015 - 10:44am
Effective Oct. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will require providers to submit the 2012 American Dental Association (ADA) claim form, or its corresponding Electronic Data Interchange (EDI) format, when filing dental or oral surgical claims services using Common Dental Terminology (CDT) procedure codes. Previously used ADA claim forms and their accompanying EDI formats will be rejected for all claims submitted on or after Oct. 1, 2015.
Tags: Dental
Post date: 07/23/2015 - 11:28am
The HIPP program is a cost-containment initiative that maintains premium payments for Medicaid beneficiaries who retain private health insurance when cost-effective to the Medicaid program. HIPP enrollment is contingent upon a HIPP applicant's Medicaid eligibility and cost-effectiveness.
Tags: All Providers
Post date: 07/02/2015 - 4:46pm
Post date: 07/02/2015 - 3:14pm
SCDHHS will implement a policy for nutritional counseling. SCDHHS is currently enrolling Licensed Dietitians (LDs) and these providers will be able to provide nutritional counseling services for obesity, effective with dates of service on or after August 1, 2015.
Tags: All Providers
Post date: 06/25/2015 - 11:11am
Effective Aug. 1, 2015, the provider enrollment application fee will only be applicable to providers that the Centers for Medicare & Medicaid Services (CMS) has identified as institutional providers.
Tags: All Providers
Post date: 06/24/2015 - 3:51pm
Effective Aug. 1, 2015, SCDHHS will amend the delivery method policy for Durable Medical Equipment (DME) providers.
Post date: 06/22/2015 - 9:44am
Beginning Aug. 17, 2015, the electronic claim submission web portal (Webtool) will be enhanced to allow the attachment of documentation to claims
Tags: All Providers
Post date: 06/01/2015 - 9:55am
Effective Oct. 1, 2015, claims submitted to the South Carolina Department of Health and Human Services (SCDHHS) must include the ICD-10 diagnosis or procedure codes for any claim with a date of service or date of discharge on or after Oct. 1, 2015.
Tags: All Providers, ICD-10
Post date: 05/26/2015 - 9:58am
This policy applies only to the S.C. Medicaid Fee-for-Service (FFS) benefit.
Post date: 05/26/2015 - 9:52am
Effective for dates of service on or after July 1, 2015, trained staff in a primary care setting must begin billing Current Procedural Terminology (CPT) code 99188 on the CMS-1500 form when applying fluoride varnish.
Tags: All Categories
Post date: 05/22/2015 - 9:16am
Effective July 1, 2015, SCDHHS will no longer require incontinence supply providers to obtain a Medicaid Certificate of Medical Necessity (MCMN) (Form DME001) for gloves provided to Healthy Connections Medicaid members enrolled in the Community Support Waiver, Head and Spinal Cord Injury Waiver and Intellectual Disabilities/Related Disabilities Waiver.
Post date: 05/22/2015 - 9:11am
Effective with dates of service on or after July 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will carve out coverage for medications used to treat Hepatitis C Virus (HCV) from the Managed Care Organization (MCO) benefit.
Post date: 05/06/2015 - 11:11am
SCDHHS no longer requires a physical examination during an initial Family Planning visit in order to prescribe hormonal contraception.
Tags: Physicians
Post date: 04/22/2015 - 12:54pm
Members 0-21 years old are eligible to submit requests for ASD services, including members currently on the Pervasive Developmental Disorder (PDD) Waiver waiting list as well as those whose PDD Waiver services have expired.
Tags: EPSDT Screening Clinics
Post date: 04/20/2015 - 2:41pm
Providers enrolled in the South Carolina Healthy Connections Medicaid program must have their enrollment revalidated by SCDHHS on or before March 25, 2016.
Tags: All Providers
Post date: 04/13/2015 - 7:12pm
The South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the Rehabilitative Behavioral Health Services (RBHS) policy. These changes apply to fee for service RBHS only and are effective May 1, 2015, unless otherwise specified in this bulletin.
Post date: 03/31/2015 - 4:47pm
Effective January 1, 2015, SCDHHS added Current Procedural Terminology (CPT) code 96127 to break out the services of emotional and behavioral assessments from developmental screening reported with CPT code 96110.
Post date: 03/13/2015 - 12:38pm
On Feb. 20, the South Carolina Department of Health and Human Services (SCDHHS) released a bulletin on changes to the Rehabilitative Behavioral Health Services (RBHS) policy, effective March 1, 2015. These changes, which only apply to fee for service, include medical necessity and prior authorizations, staff credentials, staff to client ratio, frequency limits and reimbursement rates and modifier changes.
Tags: All Providers
Post date: 03/02/2015 - 3:24pm
Changes to Federally Qualified Healthcare Centers (FQHCs) enrollment and claims submission criteria.
Tags: Medical Clinics
Post date: 02/20/2015 - 7:20pm
Effective March 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the Rehabilitative Behavioral Health Services (RBHS) policy. These changes apply to fee for service RBHS only.
Post date: 02/13/2015 - 4:11pm
Effective immediately, the following codes are now billable under the Healthy Connections Checkup (Checkup) colorectal cancer screening benefit. These services are available once every 10 years for patients 50-75 years old. An FP modifier must be appended to the following Current Procedural Terminology (CPT) codes.
Tags: All Providers
Post date: 02/06/2015 - 3:28pm
Effective immediately the South Carolina Department of Health and Human Services (SCDHHS) is imposing a moratorium on the enrollment of Rehabilitative Behavioral Health Services providers.
Tags: All Providers
Post date: 02/04/2015 - 10:33am
On July 3, 2014, the Food and Drug Administration issued updated guidance in regards to hydroxyprogesterone caproate.
Post date: 01/27/2015 - 1:40pm
New Billing Procedure Code for Child and Adolescent Level of Care Utilization System (CALOCUS) &
Procedure Code Change for Initial Assessment
Post date: 01/16/2015 - 10:03am
SCDHHS’ payment for dual-eligible (Medicaid and Medicare) members is equal to the allowed amount minus the Medicare payment or the sum of the Coinsurance, Deductible and Blood Deductible (up to three units), whichever is less.
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