Dental

The South Carolina Department of Health and Human Services (SCDHHS) is issuing the following dental policy updates, effective July 1, 2018.

1. Request for Reconsideration: SCDHHS and DentaQuest will refer to the former claim appeals process as the request for reconsideration process. The process itself remains the same and no changes or additional actions are required from providers. DentaQuest will reference the request for reconsideration in future communications. 

The South Carolina Department of Health and Human Services (SCDHHS) is clarifying the policy for dental procedure fee inclusions.

The reimbursement fee for a dental procedure is inclusive of any items or related activities/services that are considered necessary to accomplish the procedure, which may include but are not limited to: materials, supplies, trays, surgical trays, equipment, topical or local anesthesia and post-operative care. None of these items or related activities/services are separately billable to SCDHHS, the beneficiary or to the beneficiary's representative.

The South Carolina Department of Health and Human Services (SCDHHS) has updated the reimbursement rates, effective for dates of service on or after July 1, 2017, for the dental procedure codes listed on the following page.

The updated dental fee schedule will be accessible on the SCDHHS website, scdhhs.gov, July 1, 2017.

For questions regarding this update, please contact the DentaQuest Provider Service Center at (888) 307- 6553.

The South Carolina Department of Health and Human Services (SCDHHS) encourages all dental providers to review the latest version of the Dental Office Reference Manual (ORM) effective May 1, 2017.

The ORM includes clarifications to the following policy sections:

In recent years, the South Carolina Department of Health and Human Services (SCDHHS) has worked to support the increase of eligible providers' adoption and use of Certified Electronic Health Record Technology (CEHRT) and health information exchange (HIE) through the South Carolina Medicaid Electronic Health Records (EHR) Incentive Program. This program provides incentive payments to eligible professionals (EP) and eligible hospitals (EH) as they adopt, implement, upgrade (AIU) or demonstrate meaningful use (MU) of CEHRT.