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Provider Guides
Most Recently Updated Guides.
Go to Provider Guides List for the full list of all provider guides.
Monday, July 1, 2019
Monday, July 1, 2019
Excluded Providers List
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Provider Lists
- Provider Type and Specialty Listing 04/01/19
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- South Carolina Excluded Providers
For Questions
Guide Resources
Federal Resources
- Centers for Medicaid and Medicare Services
- National Plan and Provider Enumeration System (NPPES) for NPI
- Provider Taxonomy Code Set
- Office of Inspector General (OIG)
- System for Award Management (SAM)
Training and FAQs
Credit Balance Forms
SC Medicaid eLearning
Resources
Fee Schedules
CLTC Fee Schedule CLTC Fee Schedule.xls Private Mental Health Fee Schedule Private Mental Health Fee Schedule.xlsx Audiology Fee Schedule Audiology...
South Carolina Child Advocate
Do you have a complaint regarding services being provided to a child by a state agency? Please submit your complaint by phone (1-800-206-1957) or an...
Archived Provider Manuals
Alcohol and Other Drug Rehabilitation Services Provider Manual Description: Links to view/download individual sections; and a link to download...
Carrier Codes
Megallan Carrier Code List Alpha03/31/2019 (MS Excel Spread sheet) Megallan Carrier Code List Numeric03/31/2019 (MS Excel Spread sheet) Carrier...
Community Engagement Section 1115 Demonstration Waiver
The South Carolina Department of Health and Human Services (SCDHHS) will submit a section 1115 demonstration waiver application to the Centers for...
BABYNET
Full BabyNet Site Young children learn and develop differently. One baby may walk earlier than another, while another baby might talk first. Often,...
Electronic Data Interchange (EDI)
Electronic claims are processed faster and more accurately than those received by mail. SCDHHS will provide an electronic response indicating that...
Section 1115 Demonstration Waiver Preconception Care (PCC)
SCDHHS will submit a Section 1115 Demonstration Waiver application to the Centers for Medicare & Medicaid Services (CMS)to implement a...
New Medicare ID Cards Are Coming
Starting April 2018 through April 2019, Medicare will begin mailing new ID cards to all people with Medicare. Social security numbers are being...
Autism Spectrum Disorder Services
View Autism Spectrum Disorder Services Site Effective July 1, 2017, the South Carolina Title XIX State Plan will include covered autism spectrum...
EPSDT
For more information view the Full Site Early Periodic Screening, Diagnosis and Treatment, or EPSDT, is the Medicaid program's benefit that covers...
Psychiatric Residential Treatment Facility (PRTF) Carve-In Frequently Asked Questions (FAQs)
Effective July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will include Psychiatric Residential Treatment Facility (...
File Appeals & Reschedule/Cancel Hearings Online
You can now file your appeal online and make requests to reschedule or cancel hearings and withdraw appeal requests on the new Appeals and Hearings...
RBHS Carve-In
Effective July 1, 2016, the SCDHHS will include outpatient mental health services and Rehabilitative Behavioral Health Services (RBHS) as part of the...
Palmetto Coordinated System of Care
The Palmetto Coordinated System of Care is a program to help children stay: at home in school when possible, out of the child welfare system, and...
SC Medicaid Companion Guides
South Carolina Medicaid Companion Guides supplement the HIPAA-required ANSI X-12 Implementation Guide to explain billing instructions specific to...
APR-DRG
The South Carolina Department of Health and Human Services (SCDHHS) intends to move to a new method of paying for hospital inpatient services. The...
ICD-10
Read More about the ICD-10 Implementation The South Carolina Department of Health and Human Services (SCDHHS) is moving forward in updating our...
HCBS Final Rule
The Home and Community-Based Services (HCBS) rule creates a more outcome-oriented definition of home and community-based settings. It does not just...
Healthy Connections Checkup
Medicaid has added to our Family Planning benefit and now offers screenings and a physical exam. We still cover birth control and now also cover:
New Tool! SC HealthViz
Access maps, reports and data on Medicaid health services in South Carolina SC HealthViz is designed to provide greater transparency of the data that...
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Organizations
Transportation Advisory Committee
The advisory committee shall meet at least quarterly to review issues and complaints concerning the Medicaid Transportation Brokerage System and...
Medical Care Advisory Committee
The Medical Care Advisory Committee (MCAC) of the South Carolina Department of Health & Human Services advises the Department of Health and Human...
South Carolina Birth Outcomes Initiative
2018 South Carolina Birth Outcomes Initiative Symposium 2018 South Carolina Birth Outcomes Initiative Symposium Promo Video 2018 South Carolina Birth...
Estate Recovery
In August of 1993, Congress passed a law that requires states to recover amounts that Medicaid has paid for certain recipients. In South Carolina the...
Adult Protection Coordinating Council
The Adult Protection Coordinating Council was created by the South Carolina General Assembly to foster coordination and cooperation among multiple...
Screening, Brief Intervention and Referral to Treatment (SBIRT)
What is SBIRT? SBIRT is evidence based, integrated and comprehensive approach to the identification, intervention treatment/referral of substance (...
Money Follows the Person
Home Again is a program assisting seniors, individuals with disabilities, and children with severe emotional disturbances who currently live in...
Home Health
Conditions and Criteria for Home Health Services: Home Health Services are intermittent skilled nursing services, physical therapy, speech therapy,...
Division of Community and Facility Services
The Division of Community and Facility Services is responsible for oversight for the following Medicaid programs: home health, hospice,nurse aide...
Nurse Aide Registry, Testing and Training
The South Carolina Healthy Connections Medicaid is committed to ensuring that anyone who is interested in becoming a Certified Nursing Assistant (CNA...
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Latest Provider Bulletins 
Jul 12, 2019
Jul 10, 2019
Jun 28, 2019
Apr 5, 2019