For Providers

Fee Schedules

Physicians Enhanced Qualifying Primary Care 2015_EN_QUAL_PRI_CARE_SCHED.xlsx 2015_EN_QUAL_PRI_CARE_SCHED.pdf Family Practice, General Practice,...

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...

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...

Carrier Codes

  Megallan Carrier Code List Alpha 6/1/2016 (MS Excel Spread sheet) Megallan Carrier Code List Numeric 6/1/2016 (MS Excel Spread sheet)...

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)

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...

Report Fraud