For Providers
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...