Rehabilitative Behavioral Health and Substance Use Services Rate Increases
Effective for dates of service on or after Dec. 1, 2025, the South Carolina Department of Health and Human Services (SCDHHS) will update the reimbursement methodology and rates for Medicaid State Plan-covered services rendered by rehabilitative behavioral health services (RBHS) providers, Office of Substance Use Services-affiliated organizations and licensed independent practitioners (LIPs). Additionally, the Department of Alcohol and Other Drug Abuse Services Fee Schedule, which currently provides the reimbursement rates for substance use services, will be renamed to align with the Office of Substance Use Services.
Reimbursement Rate Increases
Updated reimbursement rates for services defined in the RBHS Manual, including substance use services, and the LIP Rehabilitative Services Manual are available in the rate tables listed below. For RBHS and substance use services, the reimbursement rates will be reflected in the corresponding fee schedules available on SCDHHS' website by Dec. 1, 2025. For services included in the LIP Rehabilitative Services Manual, reimbursement rates will be reflected in a LIP fee schedule that will be added to SCDHHS’ website by Dec. 1, 2025. The reimbursement methodology and rate updates will not impact the evidence-based practices defined in the appendices of the RBHS Manual.
Updated Rates for the RBHS Fee Schedule
| Description | Procedure Code | Modifier | Current Rate per Unit | New Rate per Unit as of Dec. 1, 2025 |
|---|---|---|---|---|
| Behavioral Health Screening | H0002 | AF HP AM SA AH HO HN | $37.13 (unit = 15 min.) $36.09 $18.49 $17.29 $18.72 $12.82 $11.23 | $83.45 (encounter) $81.11 $41.56 $38.86 $42.07 $28.81 $25.24 |
| Psychiatric Diagnostic Evaluation without Medical Services – Comprehensive Diagnostic Assessment | 90791 | AH HO | $235.86 $161.55 | $236.92 $162.27 |
| Psychiatric Diagnostic Assessment with Medical Services | 90792 | AF AM SA | $445.60 $221.82 $201.74 | $500.74 $248.64 $233.10 |
| Mental Health Comprehensive Assessment – Follow-Up | H0031 | AH HO | $117.94 $80.78 | $118.46 $81.14 |
| Child and Adolescent Level of Care Utilization System (CALOCUS) Assessment | H2000 | AH HO | $224.63 $153.94 | $252.43 $172.99 |
| Service Plan Development Interdisciplinary Team with Client | 99366 | 00 | $39.54 | $44.43 |
| Service Plan Development Interdisciplinary Team with Client | 99367 | 00 | $39.54 | $44.43 |
| Service Plan Development by Non-Physician | H0032 | AH HO HN | $12.32 $8.44 $7.04 | $52.06 $35.66 $31.38 |
| Updated Rates for the RBHS Fee Schedule | ||||
| Individual Psychotherapy Face-to-Face – 30 minutes | 90832 | AF AM SA AH HO | $104.94 $53.74 $50.25 $57.15 $39.14 | $155.10 $77.01 $72.20 $78.08 $53.48 |
| Individual Psychotherapy Face-to-Face – 45 minutes | 90834 | AF AM SA AH HO | $209.88 $107.48 $100.50 $114.30 $78.29 | $310.22 $154.04 $144.41 $156.18 $106.97 |
| Individual Psychotherapy Face-to-Face – 60 minutes | 90837 | AF AM SA AH HO | $314.82 $161.22 $150.75 $171.45 $117.43 | $413.62 $205.38 $192.55 $208.24 $142.63 |
| Family Psychotherapy, with and without Patient | 90846 and 90847 | HP AH HO | $301.17 $163.99 $112.32 | $432.83 $224.09 $153.49 |
| Group Psychotherapy | 90853 | AH HO | $25.52 $17.48 | $34.71 $23.78 |
| Multiple Family Group Psychotherapy | 90849 | AH HO | $24.30 $16.65 | $79.54 $54.48 |
| Medication Management | H0034 | AF HP AM SA TD TE | $24.29 $23.61 $12.09 $11.30 $10.20 $6.68 | $27.30 $26.54 $13.55 $12.71 $11.48 $7.53 |
| Psychosocial Rehabilitation Services – Individual | H2017 | U1 U2 U3 U4 U5 U6 U7 U8 U9 UA | $13.02 $9.93 $9.00 $10.85 $5.98 $6.52 $4.96 $4.50 $5.42 $3.00 | $14.63 $11.16 $10.11 $12.19 $6.72 $7.33 $5.57 $5.06 $6.09 $3.37 |
| Updated Rates for the RBHS Fee Schedule | ||||
| Behavioral Modification Service | H2014 | AF HP AM SA AH HO HN TD TE HM | $25.82 $25.10 $12.85 $12.02 $13.02 $8.92 $7.81 $10.85 $7.11 $5.98 | $29.02 $28.21 $14.44 $13.51 $14.63 $10.02 $8.78 $12.19 $7.99 $6.72 |
| Family Support | S9482 | AF HP AM SA AH HO HN TD TE HM | $25.82 $25.10 $12.85 $12.02 $13.02 $8.92 $7.81 $10.85 $7.11 $5.98 | $29.07 $28.27 $14.43 $13.53 $14.63 $10.02 $8.82 $12.23 $8.02 $6.72 |
| Community Integration Services | H2030 | U6 U7 U8 U9 | $6.52 $4.96 $4.50 $5.42 | $7.33 $5.57 $5.06 $6.09 |
| Peer Support Services | H0038 | 00 HQ | Individual: $3.31 Group: $2.32 | Individual: $3.72 Group: $2.61 |
| Crisis Management | H2011 | AF HP AM SA AH HO HN | $56.12 $54.55 $27.94 $26.12 $29.70 $20.35 $16.97 | $110.29 $107.25 $54.77 $51.34 $55.53 $38.03 $33.47 |
| Updated Rates for the LIP Fee Schedule | ||||
| Description | Procedure Code | Modifier | Current Rate per Unit | New Rate per Unit as of Dec. 1, 2025 |
| Behavioral Health Screening | H0002 | AH HO | $17.41 (unit = 15 min.) $11.92 | $42.07 (encounter) $28.81 |
| Psychiatric Diagnostic Evaluation without Medical Services – Comprehensive Diagnostic Assessment | 90791 | AH HO | $235.86 $161.55 | $236.92 $162.27 |
| Mental Health Comprehensive Assessment – Follow-Up | H0031 | AH HO | $117.94 $80.78 | $118.46 $81.14 |
| Child and Adolescent Level of Care Utilization System (CALOCUS) Assessment | H2000 | AH HO | $224.63 $153.94 | $252.43 $172.99 |
| Service Plan Development Interdisciplinary Team with Client | 99366 | 00 | $39.54 | $44.43 |
| Service Plan Development Interdisciplinary Team without Client | 99367 | 00 | $39.54 | $44.43 |
| Individual Psychotherapy Face-to-Face – 30 minutes | 90832 | AH HO | $57.15 $39.14 | $78.08 $53.48 |
| Updated Rates for the LIP Fee Schedule | ||||
| Individual Psychotherapy Face-to-Face – 45 minutes | 90834 | AH HO | $114.30 $78.29 | $156.18 $106.97 |
| Individual Psychotherapy Face-to-Face – 60 minutes | 90837 | AH HO | $171.45 $117.43 | $208.24 $142.63 |
| Family Psychotherapy, with and without Patient | 90846 and 90847 | AH HO | $163.99 $112.32 | $224.09 $153.49 |
| Group Psychotherapy | 90853 | AH HO | $25.52 $17.48 | $34.71 $23.78 |
| Crisis Management | H2011 | AH HO | $29.70 $20.35 | $55.53 $38.03 |
| Updated Rates for Substance Use-Specific Services | ||||
| Description | Procedure Code | Modifier | Current Rate per Unit | New Rate per Unit as of Dec. 1, 2025 |
| Behavioral Health Screening | H0002 | AF AM SA AH HO HN | $37.13 (unit = 15 min.) $18.49 $17.29 $18.72 $12.82 $11.23 | $83.45 (encounter) $41.56 $38.86 $42.07 $28.81 $25.24 |
| Alcohol and Drug Assessment | H0001 | AH HO U2 HN TS | $177.03 $177.03 $38.95 $155.01 $91.24 | $198.94 $198.94 $43.77 $174.19 $102.53 |
| Updated Rates for Substance Use-Specific Services | ||||
| Alcohol and/or Substance Abuse Structured Screening and Brief Intervention Services | 99408 | AF AM SA AH HO HN TD TE | $56.98 $26.78 $19.94 $19.94 $19.94 $19.94 $19.94 $12.54 | $64.03 $30.09 $22.41 $22.41 $22.41 $22.41 $22.41 $14.09 |
| Psychiatric Diagnostic Assessment with Medical Services | 90792 | AF AM SA | $174.63 $116.90 $116.90 | $500.74 $248.64 $233.10 |
| Child and Adolescent Level of Care Utilization System (CALOCUS) Assessment | H2000 | AH HO | $224.63 $153.94 | $252.43 $172.99 |
| Psychological/Neuropsychological Test Administration/Scoring by Technician, Two or More Tests Any Method; First 30 Minutes - DAODAS Only | 96138 | AH HO | $26.41 | $29.68 |
| Psychological/Neuropsychological Test Administration/Scoring by Technician, Two or More Tests Any Method; Additional 30 Minutes - DAODAS Only | 96139 | AH HO | $26.41 | $29.68 |
| Updated Rates for Substance Use-Specific Services | ||||
| Psychological/Neuropsychological Test Administration/Scoring, Single Automated Instrument via Electronic Platform, Automated Result Only - DAODAS Only | 96146 | AH HO | $26.41 | $29.68 |
| Service Plan Development by Non-Physician | H0032 | 00 HF | $26.10 $45.71 | $35.66 $53.48 |
| Individual Psychotherapy Face- to-Face for 30 minutes with Medical Evaluation and Management Services | 90833 | AF AM SA AH HO | $97.02 $64.95 $64.95 -- -- | $109.03 $72.99 $72.99 $74.00 $50.68 |
| Individual Psychotherapy Face- to-Face for 45 minutes with Medical Evaluation and Management Services | 90836 | AF AM SA AH HO | $174.30 $116.90 $116.90 -- -- | $195.88 $131.37 $131.37 $133.20 $91.22 |
| Individual Alcohol and Drug Substance Abuse Counseling | H0004 | 00 | $22.31 | $25.07 |
| Group Alcohol and Drug Substance Abuse Counseling | H0005 | 00 | $48.48 | $54.48 |
| Individual Psychotherapy Face- to-Face - 30 minutes | 90832 | SA AH HO | $63.07 $49.66 $49.66 | $72.20 $78.08 $53.48 |
| Individual Psychotherapy Face- to-Face – 45 minutes | 90834 | AF AM SA AH HO | $286.50 $134.66 $94.55 $74.49 $74.49 | $310.22 $154.04 $144.41 $156.18 $106.97 |
| Updated Rates for Substance Use-Specific Services | ||||
| Individual Psychotherapy Face-to-Face – 60 minutes | 90837 | AF AM SA AH HO | $382.00 $179.54 $126.06 $99.32 $99.32 | $413.62 $205.38 $192.55 $208.24 $142.63 |
| Family Psychotherapy, with or without Patient | 90846 and 90847 | AF AM SA AH HO | $382.00 $179.54 $126.06 $99.32 $99.32 | $445.11 $221.02 $207.21 $224.09 $153.49 |
| Psychosocial Rehabilitation Services – Individual | H2017 | 00 HQ | $7.81 (Individual and group) | $8.78 (Individual and group) |
| Skills Training and Development Service – 0 – 6 Years of Age | H2014 | 00 | $7.81 | $8.78 |
| Peer Support Service | H0038 | 00 HQ | $3.31 $2.32 | $3.72 $2.61 |
| Crisis Management | H2011 | 00 HF | Face-to-Face: $19.31 Telephonic: $19.31 | Face-to-Face: $38.03 Telephonic: $28.52 |
| Alcohol and/or Drug Treatment - Day Treatment/Partial Hospitalization Level II.5 | H2035 | 00 | $27.84 | $53.64 |
| Alcohol and/or Drug Services SubAcute Detox Residential - Clinically Managed Residential Detoxification Level III.2-D | H0010 | 00 | $96.92 | $108.91 |
| Updated Rates for Substance Use-Specific Services | ||||
| Alcohol and/or Drug Services Acute Detox Residential - Medical Monitored Residential Detoxification Services Level III.7-D | H0011 | 00 | $332.14 | $373.24 |
| Behavioral Health-Long-term Residential Treatment Program-Clinically Managed High-Intensity Residential Treatment Level III.5-R | H0019 | 00 | $193.82 | $217.81 |
| Behavioral Health - Short-term Residential Treatment Program - Medically Monitored Intensive Level III.7-R | H0018 | 00 HA | $266.23 $321.52 | $299.18 $361.31 |
Note: Only procedure codes and modifiers reflecting a rate change are included in these tables.
Providers should note that one procedure code, H0002, was converted from a 15-minute unit to an encounter in all fee schedules to reflect coding as per the National Correct Coding Initiative.
South Carolina's Medicaid managed care organizations (MCOs) are responsible for the authorizations, coverage and reimbursement related to the services described in this bulletin for members enrolled in an MCO.
Providers should direct any questions related to this bulletin to MedicaidStatePlan@scdhhs.gov or the Provider Service Center (PSC). PSC representatives can be reached at (888) 289-0709 from 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. Providers can also submit an online inquiry here.