Actions Regarding Its Methods And Standards For Setting Payment Rates



The South Carolina Department of Health and Human Services (SCDHHS), pursuant to the requirements of Section 1902(a)(13)(A) of the Social Security Act, gives notice of the following  actions regarding its methods and standards for setting payment rates for South Carolina Department of Mental Health (SCDMH) nursing facilities, long term psychiatric hospitals, and psychiatric residential treatment facilities under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or after November 1, 2013, SCDHHS will amend the South Carolina Title XIX reimbursement methodology for the SCDMH nursing facilities, long term psychiatric hospitals, and the psychiatric residential treatment facilities (PRTF) by updating the Medicaid reimbursement rates based upon the state fiscal year ending June 30, 2012 Medicaid cost reports and updated trend factors.

SCDHHS will implement the above changes in order to determine Medicaid reimbursement rates based upon the most recent cost report data available and to provide reimbursement that closely approximates allowable Medicaid reimbursable costs.

As a result of the actions described above, the following weighted average rates are reflected below.

Provider Type

Nov. 1, 2013 Wtd. Avg. Rate

Oct. 1, 2012 Wtd. Avg. Rate

Incr./(Decr.) in Rate

%  Incr./(Decr.) in Rate

Nursing Facility





LT Psych. Hospital










SCDHHS projects that based upon the action, annual aggregate expenditures for SCDMH nursing facilities, psychiatric long term hospitals, and PRTFs will increase by approximately $2,600,000 (total dollars).

Copies of this notice are available at each County Department of Health and Human Services Office and at for public review.  Additional information concerning the action is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at the SCDHHS, Bureau of Reimbursement Methodology and Policy, Room 1209, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.

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