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MedicaidCoverageMedium impact

Medicaid Coverage of Limited Services for Incarcerated Juveniles

South Dakota Medicaid·SD · Pediatrics, Family Medicine, General Practice·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Effective January 1, 2025, South Dakota Medicaid now covers limited services (targeted case management, screenings, diagnostics, and immunizations) for incarcerated juveniles within 30 days of release post-adjudication. Services must be billed with place of service code 09 and secondary diagnosis Z65.1.

Action Required

Action needed
Immediately: Billing team must update system to allow billing for incarcerated juveniles with place of service code 09 and require secondary diagnosis Z65.1 for covered services. Update encounter forms to include these requirements. Verify juvenile eligibility by emailing DSSEACorrectionsMedicaid@state.sd.us with required information.

Affected Billing Codes

T1017
99383
99384
99385
99393
99394
99395
99202
99203
99204
99205
99212
99213
99214
99215
36415
Z65.1