All Providers

Bulletins and Information for All Medicaid Providers

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.

Logisticare - Corrective Action Plan to Address Non-compliance

 

This bulletin is to notify all service providers that the South Carolina Department of Health and Human Services (SCDHHS) has placed Logisticare on notice that a Corrective Action Plan (CAP) update is required in accordance with the SCDHHS Non-Emergency Medical Transportation (NEMT) contract.

This CAP addresses the following contractual requirements:

Medicaid cards now have a new design

Medicaid cards have been updated to reflect the new Healthy Connections logo, as pictured at right.

Cards with the previous design (below) are still in use and valid too, so please accept either version from your Medicaid beneficiaries.

Discontinuation of Edit Correction Forms (ECFs)

The South Carolina Department of Health and Human Services is improving provider communications regarding the status of claims submitted to SC Medicaid.  Effective January 3, 2014, providers will no longer receive Edit Correction Forms (ECFs) for rejected claims.  Additionally, effective April 1, 2014, SC Medicaid will no longer accept provider corrected ECFs.  Providers will be required to submit a new claim form to resolve billing edits.

Transition to the CMS-1500 Health Insurance Claim Form (02-12) version

In response to guidelines recommended by the National Uniform Claim Committee (NUCC) and set forth by the Centers for Medicare and Medicaid Services (CMS), the South Carolina Department of Health and Human Services (SCDHHS) is implementing the revised CMS-1500 Health Insurance Claim Form (02-12) version effective January 6, 2014.

Although the CMS-1500 form (02-12) is effective January 6, 2014, use of the revised form is optional until March 31, 2014.  The transitional dual acceptability period of the current and the revised forms is described as follows:

Tetanus, Diphtheria and Pertussis (Tdap) Vaccine

 

Medical providers who “buy and bill” for the Tdap vaccine should use the Current Procedural Terminology (CPT) code 90715.  For administration of the vaccine, providers should bill CPT code 90471 or 90472, as appropriate. 

Tdap vaccines will also be covered through the pharmacy benefit for adult beneficiaries, so long as a prescription is provided for the vaccine.  Pharmacy providers should submit claims for the Tdap vaccine through the point-of-sale (POS) system. 

Managed Care Organizational Changes. Explanation of the Organizational Changes

  1. Managed Care Organizational Changes

Effective January 1, 2014, all current Medical Home Networks (MHN) Plans operating within the state will become Managed Care Organizations (MCO) either through acquisition or conversion.

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