Updates to Personal Care and Nursing Rates for HCBS and State Plan Services

MB# : 
22-012

The South Carolina Department of Health and Human Services (SCDHHS) is increasing specific reimbursement rates for the personal care and nursing services included in this bulletin for State Plan and home and community-based waiver services (HCBS).

Rate Increases for State Plan Personal Care and Nursing Services

Effective July 1, 2022, reimbursement rates for the below listed services rendered to Healthy Connections Medicaid members covered by the State Plan will be increased as follows:

Description

Code

Current Rate

New Rate

Children’s Personal Care

T1019

$18.40/hour

$19.40/hour

Enhanced Nursing, RN

T1002

$40.80/hour

$45/hour

Enhanced Nursing, LPN

T1003

$31.80/hour

$35/hour

Rate Increases for HCBS Waiver Personal Care and Nursing Services

Effective July 1, 2022, reimbursement rates for the below listed services rendered to Healthy Connections Medicaid members enrolled in the 1915(c) HCBS waivers will be increased as follows:

Description

Code

Current Rate

New Rate

Affected Waivers

Personal Care I

S5130

$14/hour

$14.80/hour

Community Choices (CC)

HIV/AIDS

Ventilator Dependent (VENT)

Intellectual Disability/Related Disabilities (ID/RD)

Community Supports (CS)

Personal Care II

T1019

$18.40/hour

$19.40/hour

CC

HIV/AIDS

VENT

ID/RD

CS

Companion - Agency

S5135

$9.50/hour

$14.50/hour

CC

HIV/AIDS

Companion – Self-Directed

X0273

$7.71/hour

$12.80/hour

CC

HIV/AIDS

Attendant Care

S5125

$11.88/hour

$16.20/hour

CC

HIV/AIDS

VENT

Medicaid Nursing - RN

S9123

$37.40/hour

$39.40/hour

HIV/AIDS

VENT

ID/RD

Head and Spinal Cord Injury (HASCI)

Medicaid Nursing - LPN

S9124

$28.30/hour

$29.80/hour

HIV/AIDS

VENT

ID/RD

HASCI

The new rates, including procedure codes and modifiers, will be reflected on the Community Long Term Care (CLTC) Fee Schedule by July 1, 2022.

Providers should direct any questions related to this bulletin to SCDHHS program staff at MedicaidWaiver@scdhhs.gov.

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

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