Disabilities and Special Needs

Effective for dates of service on or after July 1, 2023, the South Carolina Department of Health and Human Services (SCDHHS) will add coverage of the ASD group treatment services described below. Additionally, the agency will increase the reimbursement rate and service limit for the ASD services listed below.

During the initial response to the coronavirus disease 2019 (COVID-19) pandemic, the South Carolina Department of Health and Human Services (SCDHHS) announced multiple policy changes. Most of these policy changes were issued using emergency authorities derived from the federal public health emergency (PHE). The COVID-19 federal PHE ended May 11, 2023.

On Nov. 22, 2022, the South Carolina Department of Health and Human Services (SCDHHS) announced it was postponing the launch of the electronic visit verification (EVV) system for providers who were rendering services through the three waivers operated by the South Carolina Department of Disabilities and Special Needs (SCDDSN) (the Community Supports [CS], Head and Spinal Cord Injury [HASCI] and Intellectual Disability and Related Disabilities [ID/RD] waivers).

*Jan. 5, 2023, Update: SCDHHS is updating its guidance previously published in Medicaid Bulletin 22-033 to clarify that the rate for children’s personal care state plan services (procedure code T1019) was also increased to $25.00/hr. effective Jan.

The South Carolina Department of Health and Human Services (SCDHHS) is retroactively increasing reimbursement rates for the specific services included in this bulletin. This includes early intervention services and services provided through the Intellectual Disability/Related Disabilities (ID/RD), Community Supports (CS) and Head and Spinal Cord Injury (HASCI) waivers operated by the South Carolina Department of Disabilities and Special Needs (SCDDSN).

SCDDSN-operated Waiver Services Rate Increases

The South Carolina Department of Health and Human Services (SCDHHS) is postponing the previously announced launch of the electronic visit verification (EVV) system for providers rendering in-home services to Healthy Connections Medicaid members participating in the three waivers operated by the South Carolina Department of Disabilities and Special Needs (SCDDSN). This includes the Community Supports (CS), Head and Spinal Cord Injury (HASCI) and Intellectual Disability and Related Disabilities (ID/RD) waivers.

The American Rescue Plan Act of 2021 (ARPA) provided funding to enhance, expand or strengthen HCBS beyond what was available under states’ Medicaid programs as of April 1, 2021. The South Carolina Department of Health and Human Services’ (SCDHHS) ongoing evaluation of HCBS demonstrates that additional support is warranted to maintain an adequate direct care provider network. Nationally, health care providers are experiencing a shortage of direct care workers and this shortage is impacting each of South Carolina’s Medicaid HCBS programs.

During the initial response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, the South Carolina Department of Health and Human Services (SCDHHS) announced temporary policy changes designed to ensure ongoing access to care for Healthy Connections Medicaid members enrolled in HCBS waiver programs and Healthy Connections Prime.

The South Carolina Department of Health and Human Services (SCDHHS) is announcing the implementation of three changes to the Medically Complex Children Waiver (MCCW) program. The MCCW program serves children who meet hospital level-of-care and have chronic physical/health conditions that are expected to last longer than 12 months. MCCW participants must also meet the state-defined medical eligibility criteria, which evaluates the child's dependency on medications, medical supervision, hospitalizations, skilled nursing services, therapies and medical specialists.