Provider Information
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Provider Manuals
Most Recently Updated Manuals.
Go to Provider Manuals List for the full list of all provider manuals.
Monday, August 2, 2021
Monday, August 2, 2021
Monday, August 2, 2021
Excluded Providers List
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Provider Lists
- Provider Type and Specialty Listing 01/07/22
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For Questions
Manual Resources
Federal Resources
- Centers for Medicaid and Medicare Services
- National Plan and Provider Enumeration System (NPPES) for NPI
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Training and FAQs
- KePRO’s Training Schedule
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- 254/257 Elimination FAQs
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MTCM Trainings
Credit Balance Forms
SC Medicaid eLearning
Resources
Carrier Codes
Megallan Carrier Code List Alpha January 2023 (MS Excel Spread sheet) Megallan Carrier Code List Numeric January 2023 (MS Excel Spread sheet)...
Fee Schedules
Fee Schedule for COVID-19-related Codes SCDHHS has published fee schedules for codes that have been created during the COVID-19 public health...
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...
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...
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 and Periodic Screening, Diagnostic, & Treatment, or EPSDT, is the Medicaid program's benefit that...
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...
Archived Provider Manuals
Alcohol and Other Drug Rehabilitation Services Provider Manual Description: Links to view/download individual sections; and a link to download...
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...
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...
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...
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...
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
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...
Transportation Advisory Committee
The advisory committee shall meet at least quarterly to review issues and complaints concerning the Medicaid Transportation Brokerage System and...
Nursing Facility Services (Nursing Homes)
Nursing Facility Services Links Nurse Aides (CNA) Residents Family Members Nursing Facility Providers Reference Nursing Home Level of Care...
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...
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 (...
Palmetto Coordinated System of Care
For more information about Palmetto Coordinated System of Care, click here. Meetings
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...
South Carolina Birth Outcomes Initiative
South Carolina Birth Outcomes Initiative is an effort by (SCDHHS) & partners to improve health of newborns in the Medicaid program. Visit Full ...
Adult Protection Coordinating Council
The Adult Protection Coordinating Council was created by the South Carolina General Assembly to foster coordination and cooperation among multiple...
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 
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