MedicaidReimbursementMedium impact
Medicaid Reimbursement and Care Management Referral Updates
South Dakota Medicaid·SD·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid implemented a 1.25% rate increase for most services effective July 1, 2025, with targeted increases for specific transportation and physician codes. Additionally, care management referrals are no longer required for outpatient mental health services as of June 1, 2025.
Action Required
Immediately: Billing team must update fee schedules in billing system to reflect new South Dakota Medicaid rates effective July 1, 2025. Download updated fee schedules from https://dss.sd.gov/medicaid/providers/feeschedules/. For mental health services, stop requiring care management referrals for outpatient services by community mental health centers, independent practitioners, and psychiatrists (effective June 1, 2025). Update billing system to remove referral requirements for these services to prevent payment delays.