Home Health

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.

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:

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:

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.

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%.

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.