All Providers

Bulletins and Information for All Medicaid Providers

SCDHHS Offers Free Provider Workshops

 

Attached is a schedule of the free provider workshops offered by the
SCDHHS to include Medicaid Basics, Comprehensive Web Tool, Overview of
Third Party Liability and Overview of Claim-level Adjustments.

Home and Community Based Waivers Rate Increases. Clarification of Change in Reimbursement for Adult Day Health Care Transportation

 

This Medicaid bulletin is being re-sent because the rate cited for adult day health care transportation was incorrectly stated in the original bulletin dated October 2nd. We have corrected this information below and we apologize for any inconvenience this may have caused.

 

Effective November 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Adult Day Health Care (ADHC) services in the Community Long Term Care and Disabilities and Special Needs waiver programs. 

 

Quality Improvement Organization (QIO) Training Session

 

 

The South Carolina Department of Health and Human Services (SCDHHS) will co-sponsor provider/facility training with Keystone Peer Review Organization, Inc., (KePRO), the Medicaid Quality Improvement Organization (QIO).

 

Medicaid Providers of Adult Day Health Care Services Bulletin

 

Effective November 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Adult Day Health Care (ADHC) services in the Community Long Term Care and Disabilities and Special Needs waiver programs. 

 

The following table lists the current procedure code utilized for each waiver:

 

Waiver

Procedure Code

Modification to Rehabilitative Therapy Checkpoint

Effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) will be modifying the rehabilitative therapy checkpoint.  The checkpoint consists of combined hours of service to include speech-language pathology, occupational, and physical therapy for all individuals under age 21.

Home and Community Based Waivers Rate Increases for Personal Care Services

 

Effective September 1, 2012, The South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Personal Care Services in the Home and Community Based waiver programs. 

 

The following table lists the current procedure code utilized for each waiver:

 

Program

Procedure Code

Convenient Care Clinics Provider Enrollment and Place of Service Code 17

 

Effective with dates of service on or after August 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) provider enrollment policy will now allow Convenient Care Clinics (CCC) to enroll as a provider group for billing purposes. CCC’s are located in retail stores, supermarkets and pharmacies and are able to treat uncomplicated minor illnesses and provide preventative healthcare services.  They are often referred to as retail clinics, retail-based clinics or walk-in medical clinics.

 

New Services Performed by KePRO, the Quality Improvement Organization (QIO) for S.C. Medicaid

 

Effective August 1, 2012 the following will be added to the list of services that require prior authorization (PA) from KePRO.   

 

Durable Medical Equipment (DME)

 

Four Regional Provider/Stakeholder Meetings To Explore Options For Optional State Supplementation (OSS) Program

The South Carolina Department of Health and Human Services (SCDHHS), South Carolina Department of Mental Health (SCDMH), and the Adult Protection Coordinating Council will sponsor four regional stakeholder meetings focusing on issues related to Community Residential Care Facilities (CRCFs). These meetings will explore topics related to program enhancements for OSS, SCDMH funded services for consumers in CRCFs, and future initiatives improving quality of care in these facilities. The purpose of the sessions is to solicit input and program recommendations.

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