MedicaidAdministrativeMedium impact
Summer Provider Newsletter
South Dakota Medicaid·SD · Psychiatry, Family Medicine, OB-GYN·Education
Effective date
Jun 1, 2025
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid implemented multiple policy changes effective June 1 and July 1, 2025, including elimination of care management referrals for outpatient mental health services, inflationary rate increases up to 1.25% for services below target methodology, and expanded BabyReady program eligibility to 32 weeks gestation or less.
Action Required
Immediately: Stop requiring care management referrals for outpatient mental health services provided by community mental health centers, independent practitioners, and psychiatrists for dates of service June 1, 2025 and after. Update billing system to reflect new Medicaid fee schedules effective July 1, 2025 with rate increases up to 1.25%. Expand BabyReady program enrollment to include pregnant recipients up to 32 weeks gestation.