Pervasive Developmental Disorder (PDD) Waiver Termination

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The Centers for Medicare and Medicaid Services (CMS) issued an informational bulletin clarifying Medicaid coverage of services to children with autism on July 7, 2014. As a result of that bulletin and extensive consultation with CMS, the Pervasive Developmental Disorder (PDD) Waiver will be terminated Dec. 31, 2017.

In order to phase out the PDD Waiver in a manner that minimizes disruption to impacted beneficiaries, the process below is being implemented.

On June 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) took the following steps:

1.      SCDHHS ceased enrolling additional applicants in the PDD Waiver.

2.      SCDHHS ceased enrolling additional providers to serve beneficiaries in the PDD Waiver.

PDD Waiver waiting list applicants will be transferred to a processing list for the new state plan Autism Spectrum Disorder (ASD) Services program.

On July 1, 2017, PDD Waiver service rates will be revised as reflected in the table below.

H2000

EIBI Assessment

$679/annual assessment

H0032

EIBI Plan Implementation

$58.20/hour

G0177

EIBI Lead Therapy

$37.02/hour

H0046

EIBI Line Therapy Level I

$17.28/hour

H0046 - U2

EIBI Line Therapy Level II

$17.28/hour

T2025

Program Development and Training

$1,358/year

H0039

Self-directed EIBI Line Therapy Level I

$15.63/hour

H0039 - UA

Self-directed EIBI Line Therapy Level II

$15.63/hour

G9002

Case Management

$122.50/month

Current PDD Waiver Early Intensive Behavioral Intervention (EIBI) providers must submit a plan to Jennifer Robinson, PDD Waiver Administrator, at Jennifer.Robinson@scdhhs.gov no later than July 21, 2017, describing how they propose to transition the current beneficiaries they serve from the PDD Waiver to the new State Plan ASD Services Program. SCDHHS will review and approve these plans.

If you have any questions regarding this bulletin, please contact Jennifer Robinson at (803) 898-0563.

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

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