Rehabilitative Behavioral Health Services Changes Updates

PROVIDER ALERT

The South Carolina Department of Health and Human Services (SCDHHS) released a Medicaid Bulletin April 13, 2015, outlining new Rehabilitative Behavioral Health Services (RBHS) policy changes effective May 1, 2015. There are two updates to this bulletin.

  1. The bulletin stated that the SCDHHS will make the rate adjustments for claims filed for dates of services on or after March 1, 2015. The Department has already voided and replaced all claims for dates of service on or after March 1. For those claims that were initially billed at an amount below the revised rate, they will need to be voided and replaced by the provider in order for the new rate to be paid.
     
  2. The bulletin stated that the Early Learning Accomplishment (E-LAP) or the Child Behavior Checklist (CBCL) would be the assessment tool to accompany a Diagnostic Assessment (DA) for beneficiaries aged 0-5 upon submission to the Quality Improvement Organization (QIO). Based on additional provider input, the approved assessment tools for beneficiaries up to 5 years old will instead be the Parenting Stress Index (PSI) or the CBCL.
    1. The PSI will be the assessment tool for beneficiaries 0-18 months years old. The PSI must accompany a DA upon submission to the QIO for the population noted.
       
    2. The CBCL will be the assessment tool to accompany a DA upon submission to the QIO for beneficiaries 19 months-5 years old.
       

    The Child and Adolescent Level of Care Utilization System (CALOCUS) continues as the assessment tool to accompany a DA upon submission to the QIO for beneficiaries 6-21 years old.

 

Unless otherwise noted, this change, along with the updates noted in the April 13 bulletin, Rehabilitative Behavioral Health Services Changes, are effective May 1, 2015.

Please contact the Provider Service Center at (888) 289-0709 for any questions. For answers to commonly asked questions on these RBHS service changes, please visit scdhhs.gov/rbhsfaq.

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

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