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You may reach the Medicaid Hospice Program during normal business hours. The Hospice Program Manager will be happy to answer any questions you may have on program policies and claim resolutions.

Department of Facility Services Contact Information

Andrew Lowder, Program Manager
Andrew.lowder@scdhhs.gov
Telephone: 803-898-2691
Fax: 803-255-8209



Nicole Mitchell-Threatt, Division Director
Mitcheln@scdhhs.gov
Telephone: (803) 898-2689
Fax: (803) 255-8209


Provider Manual

Medicaid Hospice Provider Manual

Billing for Nursing Facility Room and Board Training Manual

Reimbursement

Hospice rates by county FY 10/16 - 09/17

Hospice rates by county FY 10/15 - 09/16

Hospice rates by county FY 10/14 - 09/15

Hospice rates by county FY 10/13 - 09/14

Hospice rates by county FY 10/12 - 09/13

Hospice rates by county FY 10/11 - 09/12 (revised)

Hospice rates by county FY 10/10 - 09/11

Hospice rates by county FY 10/09 - 09/10

Hospice rates by county FY 10/08 - 09/09

Section 3 of the Hospice Provider Manual, Billing Procedures

Billing for Nursing Facility Room and Board Training Manual

Paper Claim Submission of Claim Form CMS-1500: Paper claims are mailed to Medicaid Claims Receipt at the following address: Medicaid Claims Receipt Post Office Box 1412 Columbia, SC 29202-1412

Billing for Dually Eligible Recipients: When a beneficiary has both Medicare and Medicaid, Medicare is considered to be the primary payer. Services rendered to persons who are certified dually eligible for Medicare/Medicaid must be billed to Medicare first. See Section 3, pages 3-1 and 3-2 of the Hospice Provider Manual

Electronic Billing For Hospice Services
Electronic Data Interchange (EDI)or see Section 3 page 3-3 of the Hospice Provider Manual

Coordination Between Hospice and CLTC

Hospice Program Forms

Medicaid Hospice Election Form, SCDHHS Form 149

Medicaid Hospice Prior Authorization Form SCDHHS Form 149A

Most Common Mistakes When Submitting Medicaid Hospice Election Forms

Medicaid Hospice Physician Certification/Recertification Form, SCDHHS Form 151

Medicaid Hospice Discharge Form, SCDHHS Form 154
The Reverse side must be printed on all Medicaid Hospice Discharge Forms

Medicaid Hospice Revocation Form, SCDHHS Form 153

Medicaid Hospice Provider Change Request Form, SCDHHS Form 152

Provider Enrollment

Hospice Provider Enrollment Procedures - Policy
See Provider Manual

SCDHEC Procedures For Licensing Hospice Programs

Medicaid Recipient Eligibility

To Check Medicaid eligibility: call 1-800-809-3040 or use the Web Tool.

Hospice Eligibility:
In order for a Medicaid beneficiary to be eligible to elect hospice care under Medicaid, that beneficiary must be certified as being terminally ill. An individual is considered terminally ill if he or she has a medical prognosis that his or her life expectancy is six months or less if the disease runs its normal course.

Hospice References

Carolina Center for Hospice and Palliative Care

South Carolina Home Care and Hospice Association

Hospice Foundation of America