Prior Authorization Schedule

The South Carolina Department of Health and Human Services (SCDHHS) will implement the following one-time change to the Rehabilitative Behavioral Health Services (RBHS) prior authorization (PA) schedule for beneficiaries age 0-21. This change to the submission schedule for PAs will allow the Quality Improvement Organization (QIO) to operate more efficiently and generate a more timely response to PA requests.

This applies to the fee-for-service Community Support Services (Psychosocial Rehabilitative Services, Behavior Modification and Family Support) that require PA from KEPRO, the QIO. The schedule applies to all initial and continued treatment prior authorizations with requested service start dates in December 2015.

Beneficiaries with an odd number birth month (January, March, May, July, September and November) will receive a service authorization up to 45 days.

Beneficiaries with an even number birth month (February, April, June, August, October and December) will receive a service authorization up to 90 days.

All other PA policy requirements published in the RBHS manual and associated bulletins remain in effect.

Please contact the Provider Service Center at (888) 289-0709 for any questions regarding the fee-for-services policies indicated in this bulletin. For answers to commonly asked questions on this one-time PA schedule adjustment, please visit https://scdhhs.gov/rbhsfaq.

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

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