Expanded Coverage for ASD Services by SCDHHS

Effective for dates of service on or after July 1, 2024, the South Carolina Department of Health and Human Services (SCDHHS) will add coverage of additional autism spectrum disorder (ASD) services. This coverage expansion applies to full-benefit South Carolina Healthy Connections Medicaid members. The new covered services announced in this bulletin will be added to the ASD Services provider manual and ASD fee schedule available on SCDHHS’ website by July 1, 2024. SCDHHS is making these changes to support greater access to ASD services, enhance the state’s provider network and ensure services are delivered effectively. The addition of these services will complete the available service array for Healthy Connections Medicaid members for ASD services.

Reimbursement Rates for New ASD Services
Reimbursement rates for the additional ASD services described in this bulletin are included in the table below.

After July 1, 2024, the SCDHHS will be providing coverage for additional autism spectrum disorder services.Photo bySCDHHS

South Carolina’s Healthy Connections Medicaid managed care organizations (MCOs) are responsible for the authorizations, coverage and reimbursement related to the services described in this bulletin for Healthy Connections Medicaid members who are enrolled in an MCO.

Providers should direct any questions related to this bulletin to the Provider Service Center (PSC) at (888) 289-0709 or to behavioralhealth004@scdhhs.gov. The PSC’s hours of operations are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday.

New ASD service support goes in effect after July 1, 2024Photo bySCDHHS