SCDHHS Updates ASD Services: New Coverage and Corrected Service Limit

This serves as an update to Medicaid Bulletin MB# 24-024. MB# 24-024 announced the South Carolina Department of Health and Human Services (SCDHHS) will add coverage of additional autism spectrum disorder (ASD) services effective for dates of service on or after July 1, 2024. However, the bulletin included an incorrect service limit for procedure code 97152. Effective July 1, 2024, the service limit for procedure code 97152 will be 21 units/day. A correction has been added to the posting of MB# 24-024 on SCDHHS’ website and an updated table of new ASD services and their reimbursement rates is available below.

SCDHHS has issued an update on their ASD Services and Payments.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.

SCDHHS has updated its ASD Service and Payments.Photo bySCDHHS