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Inpatient Only Procedures


The South Carolina Department of Health and Human Services (SCDHHS) is clarifying its policy on procedures that are only reimbursable when performed as an inpatient procedure. SCDHHS follows the Centers for Medicare and Medicaid Services (CMS) Inpatient Only List for designation of inpatient only procedures. This list is available in CMS’ Outpatient Prospective Payment System (OPPS), Addendum E. The CMS listing is updated on an annual basis.

SCDHHS lists these procedures in its Hospital Services and Physicians Services provider manuals. Both manuals have been updated to reflect this clarification.

Providers should direct any questions related to this bulletin to the Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operation are 7:30 a.m. – 5 p.m. Monday – Thursday and 8:30 a.m. – 5 p.m. Friday.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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