All Providers

Bulletins and Information for All Medicaid Providers

Policy Changes to the Referral/Authorization Process


Effective with dates of service on or after July 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will implement policy changes to the Referral and Authorization process for acquiring Rehabilitative Behavioral Health Services (RBHS) and Inpatient Psychiatric Services for Children Under 21. These changes are being made in an effort to increase beneficiary access to medically necessary services and to increase efficiency of the current referral and authorization process for behavioral health services.

Retraction of SBIRT Bulletin dated March 27, 2014

All providers should disregard the South Carolina Department of Health and Human Services’ (SCDHHS) Bulletin with release date of March 27, 2014 regarding a change in the Screening, Brief Intervention and Referral to Treatment (SBIRT) codes and billing procedures effective May 1, 2014. Providers should use the codes and billing procedures they use currently to receive payment for SBIRT services until further notice. The South Carolina Department of Health and Human Services will communicate any future changes in SBIRT codes and billing procedures in the form of a provider Bulletin.

Revising Language to the Rehabilitative Behavioral Health and Local Education Agencies Manuals to Amend the Licensed Bachelor’s Social Worker’s Scope of Practice


The South Carolina Department of Health and Human Services (SCDHHS) is issuing this bulletin to offer guidance to Rehabilitative Behavioral Health and Local Education Agency Providers.  A Licensed Bachelor’s Social Worker can sign the Individual Plan of Care (IPOC) for a Medicaid beneficiary when the IPOC is not used for the purpose of medical necessity. Effective May 1, 2014, this policy will be retroactive to August 1, 2013.

Targeted Case Management Provider Training

South Carolina Healthy Connections Medicaid is hosting three training sessions for Medicaid Targeted Case Management Providers. This training will teach Providers how to access the Phoenix portal, enroll users, receive and accept/decline referrals and to document service delivery.

Medicaid Targeted Case Management Providers will be able to select from the following dates and times:

Important Alert for Providers

On February 21, 2014, SCDHHS notified providers that 1099s for the week of October 29, 2013 were overstated. SCDHHS has resolved the issue, and the agency mailed corrected 1099s on March 3, 2014 to the approximately 5,000 providers whose original 1099 was not correct.
Only those providers who received a payment from SCDHHS for the week of October 29, 2013 will receive a corrected 1099.  The corrected 1099 will display a checked box at the top center of the form to identify it as the corrected form.


Important Alert for Providers


It has come to our attention that SCDHHS incorrectly overstated payment on the IRS Form 1099 for some enrolled providers.  Only providers included in the October 29, 2013 payment cycle are affected. We are working with our technical teams and have consulted with the IRS about the best approach to correct this information on your behalf.

We are working on a resolution and will provide information and instructions as soon as they are available. 

If you have any questions, you may contact our Provider Service Center at (888) 289-0709.


High Tech Radiology Services


Effective March 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will no longer require prior authorization on High Tech Radiology services.  All other Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes requiring prior authorization or support documentation can be found in the Physicians, Laboratories and Other Medical Professional manual located at:

Avoid disruption of electronic claims submissions

Avoid disruption of electronic claims submissions: New security policies implemented by the South Carolina Department of Health and Human Services (SCDHHS) requires all Electronic Data Interchange (EDI) Submitters, EDI Vendors, Clearinghouses, Billing Agents and South Carolina Medicaid Web-based Claims Submission Tool (Web Tool) users to change their password every 60 days. Any passwords that have not been changed will expire March 1, 2014. Please log onto to change your password before that date.   

New Speech Therapy Codes


Effective with dates of services on or after January 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS), in accordance with the Current Procedural Terminology (CPT), will discontinue coverage of the deleted code for Speech Evaluation (92506) and activate the new procedure codes listed below.  The following codes will be added to the list of reimbursable codes replacing the deleted procedure code 92506:

SMA ICD-10 Provider Readiness Assessment


The purpose of this assessment is to gauge the current state of overall ICD-10 readiness among our providers and help inform how we can best assist our providers through the transition to ICD-10.  The questions in this assessment should take no more than 10 minutes to complete and all responses will remain anonymous. Please take the time now to complete this assessment.

Thank you in advance for your response.


Subscribe to RSS - All Providers
Report Fraud