MedicaidReimbursementMedium impact
Primary Care Provider Scorecard and Preventative Services
South Dakota Medicaid·SD · Family Medicine, General Practice, Internal Medicine +1 more·Education
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid will email Primary Care Provider Scorecards in September 2024 to evaluate clinic performance on preventative visits, ED visits, and colorectal screenings. Effective July 1, 2024, Medicaid increased reimbursement rates for comprehensive preventative visits (CPT codes 99381-99397) by an average of 39%.
Action Required
Immediately: Billing team should verify that updated Medicaid reimbursement rates for CPT codes 99381-99397 are reflected in billing system using the current Physician Services Fee Schedule. Providers should access Medicaid Portal to review their caseload and outreach recipients who have not had preventative visits in the last year to improve scorecard performance.