Provider Information
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Provider Enrollment Information
Provider Manuals
Most Recently Updated Manuals.
Go to Provider Manual List for the full list of all provider manuals.
Friday, August 11, 2017
Tuesday, August 1, 2017
Tuesday, August 1, 2017
Excluded Providers List
Provider Quick Links
- Production Calendar
- Online Enrollment Application
- Online Application Fee Payment
- Provider Outreach Calendar
Provider Lists
- Provider Type and Specialty Listing 06/09/17
- Ordering/Referring Eligible Provider Listing
- South Carolina Excluded Providers
For Questions
Manuals 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
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...
Fee Schedules
CLTC Fee Schedule CLTC Fee Schedule.xls Private Mental Health Fee Schedule Private Mental Health Fee Schedule.xlsx Audiology Fee Schedule Audiology...
Carrier Codes
Megallan Carrier Code List Alpha 6/30/2017 (MS Excel Spread sheet) Megallan Carrier Code List Numeric 6/30/2017 (MS Excel Spread sheet)...
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...
BABYNET
Full BabyNet Site Young children learn and develop differently. One baby may walk earlier than another, while another baby might talk first. Often,...
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...
Proviso 33.34
The 2014 budget currently includes Proviso 33.34 which-for the first time-provides funds that may only be accessed if hospitals and clinics serving...
Affordable Care Act Initiatives
South Carolina Department of Health and Human Services (SCDHHS) received final State Plan Amendment approval for the payment methodology for enhanced...
OSS Advisories
OSCAP advisory August 2013 July 1, 2013 OSCAP Advisory07/09/2013 February 2013 OSS AdvisoryDescription: OSS Advisory NewsletterPosted:01/29/2012...
Claim Submission Tool (Web Tool)
Medicaid Web-based Claims Submission Tool Send CMS-1500 and UB-04 claims and their associated adjustments to SC Medicaid via the Internet. Support...
MHN/MCO Eligibility Verification Feature Now Available
Effective Tuesday, June 12, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will add a new feature to the SC Web-based...
Organizations
Transportation Advisory Committee
The advisory committee shall meet at least quarterly to review issues and complaints concerning the Medicaid Transportation Brokerage System and...
South Carolina Birth Outcomes Initiative
2016 South Carolina Birth Outcomes Initiative Symposium Why should YOU go to the SCBOI Symposium? Registration Information South...
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...
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 (...
Adult Protection Coordinating Council
The Adult Protection Coordinating Council was created by the South Carolina General Assembly to foster coordination and cooperation among multiple...
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,...
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...
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...