Updates to Personal Care and Nursing Rates for HCBS and State Plan Services
The South Carolina Department of Health and Human Services (SCDHHS) is increasing specific reimbursement rates for the personal care and nursing services included in this bulletin for State Plan and home and community-based waiver services (HCBS).
Rate Increases for State Plan Personal Care and Nursing Services
Effective July 1, 2022, reimbursement rates for the below-listed services rendered to Healthy Connections Medicaid members covered by the State Plan will be increased as follows:
| Description | Code | Current Rate | New Rate |
|---|---|---|---|
| Children’s Personal Care | T1019 | $18.40/hour | $19.40/hour |
| Enhanced Nursing, RN | T1002 | $40.80/hour | $45/hour |
| Enhanced Nursing, LPN | T1003 | $31.80/hour | $35/hour |
Rate Increases for HCBS Waiver Personal Care and Nursing Services
Effective July 1, 2022, reimbursement rates for the below-listed services rendered to Healthy Connections Medicaid members enrolled in the 1915(c) HCBS waivers will be increased as follows:
| Description | Code | Current Rate | New Rate | Affected Waivers |
|---|---|---|---|---|
| Personal Care I | S5130 | $14/hour | $14.80/hour | Community Choices (CC) HIV/AIDS Ventilator Dependent (VENT) Intellectual Disability/Related Disabilities (ID/RD) Community Supports (CS) |
| Personal Care II | T1019 | $18.40/hour | $19.40/hour | CC HIV/AIDS VENT ID/RD CS |
| Companion - Agency | S5135 | $9.50/hour | $14.50/hour | CC HIV/AIDS |
| Companion – Self-Directed | X0273 | $7.71/hour | $12.80/hour | CC HIV/AIDS |
| Attendant Care | S5125 | $11.88/hour | $16.20/hour | CC HIV/AIDS VENT |
| Medicaid Nursing - RN | S9123 | $37.40/hour | $39.40/hour | HIV/AIDS VENT ID/RD Head and Spinal Cord Injury (HASCI) |
| Medicaid Nursing - LPN | S9124 | $28.30/hour | $29.80/hour | HIV/AIDS VENT ID/RD HASCI |
The new rates, including procedure codes and modifiers, will be reflected on the Community Long Term Care (CLTC) Fee Schedule by July 1, 2022.
Providers should direct any questions related to this bulletin to SCDHHS program staff at MedicaidWaiver@scdhhs.gov.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.