Targeted Case Management

The South Carolina Department of Health and Human Services (SCDHHS) submitted a State Plan Amendments (SPAs) for Targeted Case Management (TCM) to the Centers for Medicare and Medicaid Services (CMS), April 20, 2012. Pending CMS approval, January 1, 2013 is the proposed effective date for all Targeted Case Management SPAs.  Below are all related documents for public information:

Targeted Case Management Frequently Asked Questions

MTCM Rates

Medicaid Targeted Case Management Rates Private Providers

A face to face TCM encounter involving travel to the recipient’s home/setting will be reimbursed at the $20.00 rate. All other TCM encounters will be reimbursed at the $15.00 rate.
Procedure Code Rate / fifteen min.
T1016 T1017
$15.00/ fifteen min. $20.00/ fifteen min.


Covered Sections


MTCM SPA Changes 


State Agency Presentation

Reimbursement Methodology

Report Fraud