SCDHHS School-based Mental Health Policy Updates for July 1, 2022
The South Carolina Department of Health and Human Services (SCDHHS) is formally launching its school-based mental health services initiative effective July 1, 2022. The SCDHHS policy changes announced in this bulletin are consistent with the recommendations made by SCDHHS to improve access to school-based mental health services for children across the state.
Central to this initiative is empowering school districts to determine and choose the best method for delivering mental health services within the school setting. Through the SCDHHS policy changes announced in this bulletin, South Carolina school districts will be free to choose to:
- Continue to utilize the South Carolina Department of Mental Health (DMH) by contracting with DMH who will then bill South Carolina Healthy Connections Medicaid;
- Hire their own counselors and bill Healthy Connections Medicaid directly;
- Contract with a private provider who will bill Healthy Connections Medicaid directly; or,
- Use a combination of these delivery methods to meet the needs of the children in their district.
Through this initiative, SCDHHS has developed an alternative fee schedule to ensure schools have the provider capacity to meet the mental health needs of the state’s children. The Local Education Agencies (LEA) Services manual will be updated to include relevant guidance from the Rehabilitative Behavioral Health Services (RBHS) provider manual for services that may be reimbursed when performed in the school setting. This change will consolidate school-based services guidance into one provider manual. The LEA manual and alternative fee schedule will be available on SCDHHS’ website by July 1, 2022.
Services Eligible for the Alternative Fee Schedule When Billed in a School-based Setting
The six RBHS described below may be billed in accordance with the updated LEA provider manual and its corresponding alternative fee schedule when rendered in a school-based setting by either an employee or contractor of the school district:
- Diagnostic Assessment – initial and follow up (90791/H0031)
- Service Plan Development (H0032)
- Crisis Management (H2011)
- Individual Psychotherapy (90832/90834/90837)
- Family Psychotherapy (90846/90847)
- Group Psychotherapy (90853)
RBHS and licensed independent practitioner (LIP) providers enrolled in Healthy Connections Medicaid and who have a contract with a school district(s) for mental health services within the school setting are authorized to be reimbursed for these services.
The following professionals may be reimbursed for providing RBHS described in this bulletin in the school setting:
- Licensed Independent Social Worker
- Licensed Marriage and Family Therapist
- Licensed Professional Counselor
- Licensed Psycho-Educational Specialist
- Licensed Master Social Worker (supervision required)
- Mental Health Professional (supervision required)
- Qualified Clinical Professional (DMH only)
School District Contract with SCDHHS
SCDHHS will issue new contracts to South Carolina school districts prior to July 1, 2022, in support of this initiative. The new contract will provide school districts with the ability to utilize the alternative fee schedule, access new training resources and give them the needed flexibility to increase access to mental health counselors in school settings.
Provider Agreements with School Districts
If a provider is already an established Healthy Connections Medicaid provider, proof of the provider’s relationship with a school district, e.g., the agreement between the parties, must be submitted by the school district to SCDHHS at State_Contracts@scdhhs.gov. If school districts choose to contract with new private RBHS or LIP providers, an executed agreement will be a required component of Healthy Connections Medicaid provider enrollment.
Healthy Connections Medicaid Provider Enrollment
School districts, DMH and existing RBHS providers that are already enrolled as Healthy Connections Medicaid providers will not need to complete a new application.
Unenrolled RBHS providers will need to complete a Healthy Connections Medicaid provider application on the SCDHHS website. RBHS providers who are not currently enrolled as Healthy Connections Medicaid providers may apply beginning July 1, 2022. In addition to all standard enrollment information, they will need to include a copy of their school district agreement(s) indicating the school(s) in which they will be providing services. A training on how to complete this application and enrollment process is available on SCDHHS’ website. SCDHHS will begin enrolling new RBHS providers for the purpose of delivering RBHS to students in school-based settings as described in this bulletin on or after July 11, 2022.
Billing for Services
Claims will require specific modifier(s) to receive reimbursement and must be filed with a place of service of “03.” These modifiers are available in the alternative fee schedule and will be discussed in pre-recorded training webinars designed for provider enrollment and claims submissions. Additionally, each school will be assigned a unique ID that must be included on submitted claims. This information will also be included in the training webinars and a roster of school IDs will be published on the SCDHHS website.
Managed Care Contracting and Prior Authorization
In partnership with SCDHHS, South Carolina’s Healthy Connections Medicaid managed care organizations (MCOs) will help to streamline the MCO application process, expedite contract execution and prior authorizations, and develop and provide additional training resources. School districts with questions about the MCO application process should email the contacts listed below.
- Absolute Total Care: ATC_Contracting@centene.com
- First Choice by Select Health: Kathy McLaurin: KMcLaurin@selecthealthofsc.com
- Healthy Blue by BlueChoice: Scott Timmons: Scott.Timmons@bluechoicesc.com
- Humana Healthy Horizons: Andrea Thompson: SCBHMedicaid@humana.com
- Molina Healthcare: Kimberly Coad-Ascue: SCProviderContract@molinahealthcare.com
SCDHHS is preparing several training resources for South Carolina school district staff and behavioral health providers. Several of these resources are already available on the agency’s school-based mental health services webpage. SCDHHS will send additional communications as more resources become available.
Please direct any questions or concerns regarding the policy changes described in this bulletin to the SCDHHS Office of Behavioral Health at firstname.lastname@example.org.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.