MedicaidCoverageMedium impact
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - SOUTH CAROLINA (New)
Humana·SC · Family Medicine, General Practice, Internal Medicine +5 more·Medicaid
Effective date
May 6, 2025
We identified it
Jun 24, 2026
Summary
New Humana Medicaid policy for South Carolina establishes coverage criteria for durable medical equipment (DME) and medical supplies, effective May 6, 2025. The policy defines specific coverage requirements, repair/replacement guidelines, and lists covered/non-covered equipment with corresponding HCPCS codes.
Action Required
By May 6, 2025: Billing team must update system with new Humana Medicaid DME coverage criteria for South Carolina members. Verify all DME meets the 5-criteria definition (withstands repeated use, not useful without illness, appropriate for home use, serves medical purpose, prescribed by practitioner). Update encounter forms to capture required documentation for medical necessity. Note that duplicate equipment and comfort items are not covered.