Home Health

Home Health

Updates to Adult Day Health Care Service Rates

The South Carolina Department of Health and Human Services (SCDHHS) is increasing the reimbursement rate for the adult day health care (ADHC) service provided to Healthy Connections Medicaid members participating in waiver programs operated by SCDHHS and the South Carolina Department of Disabilities and Special Needs.

Updates to State Plan Emergency Ambulance Service Rates

The South Carolina Department of Health and Human Services (SCDHHS) is increasing reimbursement rates for specific emergency ambulance services included in this bulletin.

Rate Increases for Emergency Ambulance Services

Effective July 1, 2022, reimbursement for the below listed codes will be increased as follows:

Description

Code

Current Rate

Updates to Personal Care and Nursing Rates for HCBS and State Plan Services

The South Carolina Department of Health and Human Services (SCDHHS) is increasing specific reimbursement rates for the personal care and nursing services included in this bulletin for State Plan and home and community-based waiver services (HCBS).

Rate Increases for State Plan Personal Care and Nursing Services

Effective July 1, 2022, reimbursement rates for the below listed services rendered to Healthy Connections Medicaid members covered by the State Plan will be increased as follows:

Updates to Adult Day Health Care Transportation

The South Carolina Department of Health and Human Services (SCDHHS) is transitioning adult day health care (ADHC) transportation for Healthy Connections Medicaid members within 15 miles of their ADHC to the state’s non-emergency medical transportation (NEMT) broker, Modivcare. Previously, transportation for trips less than 15 miles from the ADHC was provided directly by the ADHC while transportation for trips longer than 15 miles from the ADHC was provided by either the ADHC or the NEMT broker. This change is effective for dates of service on or after July 1, 2022.

POSTPONED: EVV Launch for SCDDSN-operated Waivers

To ensure a smooth transition to the electronic visit verification (EVV) system for in-home services provided by the three waivers operated by the South Carolina Department of Disabilities and Special Needs (SCDDSN), the South Carolina Department of Health and Human Services (SCDHHS) and SCDDSN are adjusting the EVV launch and go live timelines, initially scheduled for April 4 and May 15.

Approval of South Carolina’s Appendix K Amendment Request for Temporary Rate Increases

As part of the South Carolina Department of Health and Human Services’ (SCDHHS) ongoing response to the state and federal states of emergency related to coronavirus disease 2019 (COVID-19), SCDHHS submitted a request to the Centers for Medicare and Medicaid Services (CMS) to amend multiple waivers with the Emergency Preparedness and Response Appendix K. The request was approved Jan. 20, 2022, and will temporarily:

Rate Increases for Certain Incontinence Supplies and DAODAS and ASD Services

Effective Jan. 1, 2022, the South Carolina Department of Health and Human Services (SCDHHS) will increase the reimbursement rates for the services and supplies mentioned below. These rate increases apply to the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes included in this bulletin.

Incontinence Supplies

SCDHHS will increase the reimbursement rates for incontinence supplies billed using the HCPCS codes listed below by 10%.

Appendix K Temporary Retainer Payment Updates and Resources

The South Carolina Department of Health and Human Services (SCDHHS) has published additional provider resources related to Appendix K temporary retainer payments. This alert is an update regarding the temporary retainer payments that may be available to certain home and community based services providers in South Carolina. These resources include updated attestation forms and are an update to the Medicaid alert issued on Sept.

Updates to the Quarterly Seclusion and/or Restraint Reporting Form

TO: Providers Indicated
 
SUBJECT: Updates to the Quarterly Seclusion and/or Restraint Reporting Form
 

MCMN Exception for Incontinence Providers

Effective July 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will no longer require incontinence supply providers to obtain a Medicaid Certificate of Medical Necessity (MCMN) (Form DME001) for gloves provided to Healthy Connections Medicaid members enrolled in the Community Support Waiver, Head and Spinal Cord Injury Waiver and Intellectual Disabilities/Related Disabilities Waiver. Incontinence supply providers are responsible for obtaining the Physician Certification of Incontinence, SCDHHS Form 168IS, prior to delivering incontinence supplies.

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