Medicaid Providers of Adult Day Health Care Services Bulletin

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Effective November 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Adult Day Health Care (ADHC) services in the Community Long Term Care and Disabilities and Special Needs waiver programs. 

 

The following table lists the current procedure code utilized for each waiver:

 

Waiver

Procedure Code

Procedure Description

Current Rate

New Rate

Community Choices

LTC10

CLTC ADHC

$42.75

$43.75

ID/RD

X6987

ID/RD ADHC

$42.75

$43.75

Community Supports

X6987

Community Supports ADHC

$42.75

$43.75

 

Effective January 1, 2013, SCDHHS will also change the method for reimbursement of transportation in the Home and Community Based Waiver programs.  This change will include reimbursement for one-way transportation to or from the ADHC center for participants within 15 miles of the center. 

 

The change will include a reimbursement of $7.50 rate for one-way transportation and a $15.00 rate for round trip transportation.  The unit of service will be 1 unit for one-way and 2 units for round trip transportation.

 

If you have questions concerning the above information, please contact your program manager at (803) 898-2590. Thank you for your continued participation in the South Carolina Medicaid Program.

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