Rate Increase for Respite Services (T1005)

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The South Carolina Department of Health and Human Services (SCDHHS) has increased the reimbursement rate for respite care services provided to Healthy Connections Medicaid members participating in waiver programs operated by the South Carolina Department of Disabilities and Special Needs (DDSN).

Effective for dates of service on or after Sept. 1, 2021, the rate for respite care services billed using Healthcare Common Procedure Coding System (HCPCS) code T1005 was increased to $4.05 per 15-minute unit. Respite care services billed under T1005 were reimbursed at $3.17 per 15-minute unit for dates of service prior to Sept. 1, 2021. This change is reflected in the Community Long Term Care (CLTC) fee schedule available on SCDHHS’ website.

The rate increase for T1005 is limited to services rendered to Healthy Connections Medicaid members participating in the following waivers:

  • Intellectual Disability/Related Disabilities (ID/RD)
  • Community Supports (CS)
  • Head and Spinal Cord Injury (HASCI)

Providers should direct any questions related to this bulletin to the Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operations are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday.

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