Bulletins
Provider Alert: Approval of South Carolina’s Appendix K Amendment Request for Temporary Rate Increases
Bulletin: Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) - Orthodontic Services
Bulletin: Adding Developmental Pediatricians to the Comprehensive Diagnostic Assessment
The South Carolina Department of Health and Human Services will be amending its autism spectrum disorder (ASD) manual to include additional providers that will be allowed to complete the comprehensive psychological assessment/testing report to determine if Medicaid beneficiaries meet medical necessity criteria for ASD services.
Bulletin: Pediatric Screening (CPT) 96127
Effective Nov. 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will limit payment for Current Procedural Terminology (CPT) code 96127 to a maximum of two units per date of service.
Bulletin: Autism Spectrum Disorder Services Interim Process
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.
Bulletin: EPSDT Pediatric Screening Tools
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.
Bulletin: Behavioral Health Screening Tools Clarification
The South Carolina Department of Health and Human Services (SCDHHS) expanded the availability of behavioral health pediatric screening tools in a Medicaid Bulletin, dated May 17, 2013.
Bulletin: Enhanced Physician Payment Reimbursement
The South Carolina Department of Health and Human Services (SCDHHS) recently received final CMS approval for its proposed payment methodology for the Affordable Care Act (ACA) Primary Care Physician rate increase for both the Fee for Service (FFS) and Managed Care Organizations (MCOs). SCDHHS continues its work on this project to ensure that it is implemented accurately, quickly and within the CMS mandates for these enhanced payments.
Bulletin: EPSDT Pediatric Screening Tools
The South Carolina Department of Health and Human Services (SCDHHS) is expanding the availability of behavioral health pediatric screening tools and providing guidance on the utilization of these tools. Best practice indicates that standardized screenings of this type are recommended to be done during the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) visits or as dictated by clinical need. This recommendation is in alignment with the American Academy of Pediatrics (AAP) recommendations regarding screening and surveillance of family and social environment for risk factors and mental health screening of children and adolescents in primary care settings.
Bulletin: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Periodicity Schedule
Effective with dates of service on or after July 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) is updating the periodicity schedule for EPSDT services to include eight (8) additional preventative visits for recipients under 21 years of age.
Bulletin: Tobacco Cessation for Pregnant Women
Effective with dates of service on or after February 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will cover Tobacco Cessation treatment for all pregnant women in accordance with Section 4107 of the Affordable Care Act, which amended Section 1905 (bb)(2) of the Social Security Act. For the complete policy and billing instructions, please review the Physician, Laboratories and Other Medical Professionals manual located on the SCDHHS website at www.scdhhs.gov.
