Rate adjustments

 

 

The South Carolina Department of Health and Human Services (SCDHHS) has revised reimbursement rates for the following codes:

  • 90791 – Psychiatric Diagnostic Evaluation without Medical
  • 90792 – Psychiatric Diagnostic Evaluation with Medical
  • 90785 – Interactive Complexity Add-On

These adjustments apply to physicians whose rates are found in the fee schedule titled All other physicians excluding Obstetrics, OB/GYN, Maternal Fetal Medicine”.  Adjustments will be made retroactive to January 1, 2013 for these physicians.

This bulletin also serves as a reminder that psychiatrists who are Board Certified in General Psychiatry and Board Certified in Child and Adolescent Psychiatry can enroll with SC Medicaid as a Pediatric Sub-Specialist.  Please complete the DHHS Pediatric Sub-Specialist Certification Form found in the Physicians, Laboratories, And Other Medical Professionals Provider Manual.

This bulletin applies to Fee-For-Service and Medical Homes Networks (MHNs). Please contact the appropriate Managed Care Organization (MCO) for their coverage policy.  If you have any questions regarding this bulletin, please contact the Provider Service Center at (888) 289-0709.

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

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