Bulletins
Bulletin: Modification to Codes that require Filing to TPL
Post Date: 06/02/2017 - 4:29pm
Effective for dates of service on or after July 1, 2017, and as required by 1902(a) (25) of the Social Security Act, the South Carolina Department of Health and Human Services (SCDHHS) will implement cost avoidance rules for the procedure codes reflected below. Service providers will be required to file claims to any liable third-party insurer before submitting a claim to SCDHHS for payment. Claims filed with SCDHHS prior to billing all liable third-party insurers and appropriately documenting the third party filing on the claim submitted to Medicaid will receive all applicable claim edits. Resolution of applicable claim edits for the issues described above are outlined in the appendices of each SCDHHS provider manual, located at https://www.scdhhs.gov/provider-manual-list .
Bulletin: Tobacco Cessation Coverage
Post Date: 06/02/2017 - 4:23pm
Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) is enhancing tobacco cessation coverage for full-benefit Medicaid beneficiaries to align with recommendations from the Centers for Disease Control and Prevention (CDC) and the American Lung Association (ALA). This update applies to both the fee-for-service and managed care Medicaid benefits.
Bulletin: Therapeutic Child Care (TCC) Requirements
Post Date: 06/02/2017 - 4:14pm
Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will allow therapeutic child care (TCC) providers to fulfill the requirement of parallel work with the primary caregiver by rendering family psychotherapy twice per month in conjunction with the TCC service. Family psychotherapy services provided to meet this requirement must be rendered within the stated frequency limits as outlined in the Rehabilitative Behavioral Health Services manual.
Bulletin: Transition Guidelines for Autism Services
Post Date: 05/04/2017 - 10:35am
As previously announced in a March 31, 2017, provider bulletin, autism spectrum disorder (ASD) treatment services will be added to the South Carolina Medicaid State Plan effective for dates of service on or after July 1, 2017.
Bulletin: Medicaid Policy Manual for Autism Spectrum Disorder
Post Date: 05/04/2017 - 10:31am
The South Carolina Department of Health and Human Services (SCDHHS) announces the new Medicaid Autism Spectrum Disorder (ASD) Provider Manual. This manual is effective July 1, 2017, and is to be used for program information and requirements, billing procedures and provider services guidelines.
Bulletin: CHANCE Waiver Services
Post Date: 05/01/2017 - 1:48pm
The Children's Health Access in Community Environments (CHANCE) waiver manual will be withdrawn from the South Carolina Department of Health and Human Services (SCDHHS) website effective June 1, 2017. The CHANCE waiver was a Psychiatric Residential Treatment Facilities (PRTF) community alternatives demonstration waiver. This waiver was discontinued in September 2014.
Bulletin: Pre-fabricated Crown Benefits and Criteria
Post Date: 03/27/2017 - 9:53am
Effective for dates of service on or after May 1, 2017, there is no limitation to the number of pre-fabricated crowns that may be placed on a patient per day. This change aligns the South Carolina Department of Health and Human Services (SCDHHS) policy with the provisions of the South Carolina Dental Sedation Act of 2014, which allows administration of sedation or anesthesia, or both, in a dentist’s office.
Bulletin: State Plan Autism Spectrum Disorder Services Line Therapy Credential Requirements
Post Date: 12/01/2016 - 5:03pm
Effective July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will require that all applied behavior analysis (ABA) line therapists, providing treatment services to beneficiaries who have been diagnosed with Autism Spectrum Disorder (ASD) and approved for ASD services via the ASD Interim Process and/or the SC Medicaid State Plan, hold a Registered Behavior Technician (RBT) credential.
Bulletin: Inclusion of Advanced Practice Registered Nurses in ordering Medical Management Only
Post Date: 11/16/2016 - 11:10am
Effective Jan. 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will include Advanced Practice Registered Nurses (APRNs) as ordering providers of Medical Management Only (MMO) for providers under the Community Mental Health provider manual.
Bulletin: Modification To Codes That Require Filing To Third-Party Insurers
Post Date: 11/08/2016 - 4:31pm
Effective for dates of service on or after Jan. 1, 2017, and as required by federal regulation, the South Carolina Department of Health and Human Services (SCDHHS) will implement cost-avoidance rules for the procedure codes reflected below.
Bulletin: Coverage of Drug Testing Codes
Post Date: 07/21/2016 - 3:21pm
Effective for dates of service beginning Jan. 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will cover the following presumptive and definitive drug testing codes at the reimbursement rates as stated in the attached table.
Bulletin: Changes to Age Limitations for Certain Dental Procedures
Post Date: 06/23/2016 - 8:58am
Effective for all claims submitted on or after Aug. 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will lower the age limitation for the codes listed in the table below. This change is to adhere to best practice guidelines.
Bulletin: Revisions to Rehabilitative Behavioral Health Services Policy and Procedures
Post Date: 06/01/2016 - 2:35pm
Changes will be effective with dates of service on or after July 1, 2016. This bulletin provides notice and an overview of revisions effective July 1, 2016; it is not intended to reflect all revisions in the manual. The RBHS manual may be subject to further change.
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