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Updated Rehabilitative Therapy and Audiological Services Provider Manual Published, Provider Webinars Announced

MB#
24-007

The South Carolina Department of Health and Human Services (SCDHHS) has published its updated Rehabilitative Therapy and Audiological Services provider manual. The manual’s former name was the Private Rehabilitative Therapy Audiological Services provider manual. As announced in Medicaid bulletin 24-001, the program information and requirements described in the Rehabilitative Therapy and Audiological Services provider manual are effective for dates of service on or after Feb. 1, 2024. The manual is available on the provider manual page of the SCDHHS website. SCDHHS appreciates providers taking time to submit feedback on the draft of the manual distributed Jan. 2, 2024.

SCDHHS will conduct two live webinars to address the updates to the manual. A recorded webinar will also be made available for viewing on the SCDHHS website. The dates, times and links to register for the live webinars are below:

The webinars will cover the following program information and requirements in each section of the updated manual. Updates include:

  • Categorizing eligible Medicaid members in groups to align with the Medicaid State Plan authority;
  • Changes to the qualified providers section to align with state and federal regulations and the Medicaid State Plan authority;
  • Changes to covered services definitions to align with federal regulations;
  • Adding definitions of the Early Periodic Screening, Diagnostic and Treatment benefit and telehealth services;
  • Clarifying reimbursement and charge limits policies; and utilization management policies and processes;
  • Updating the Reporting and Documenting section with information about health record retention and maintenance and signature requirements;
  • Adding a new Billing Guidance section, which includes information about claims filing and modifiers; and,
  • Adding a Benefit Criteria and Limitations section, which includes frequency limits and criteria for each covered procedure code.

South Carolina’s Healthy Connections Medicaid managed care organizations (MCOs) are responsible for the coverage and reimbursement of services described in this bulletin for members who are enrolled in an MCO.

Providers serving Healthy Connections Medicaid-enrolled children who are also enrolled in South Carolina’s Individuals with Disabilities Education Act Part C program, which is commonly known as BabyNet, must follow BabyNet’s rules regarding delivering services via telehealth.

Providers may direct questions related to this bulletin to 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 at: http://www.scdhhs.gov/contact-us.

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

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