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Updated Rehabilitative Behavioral Health Services and Licensed Independent Practitioners Provider Manuals
Effective date
Jul 1, 2026
Identified
Jul 3, 2026
Summary
South Carolina Medicaid has released updated provider manuals for Rehabilitative Behavioral Health Services (RBHS), Office of Substance Use Services (OSUS)-affiliated providers, and Licensed Independent Practitioners (LIP) behavioral health services effective July 1, 2026. The manuals include new billing guidance sections, unified service definitions, updated ORP requirements for psychiatrists, and reorganized appendices. Three mandatory training webinars are scheduled July 8-9, 2026. The bulletin also reinforces anti-kickback compliance requirements under state and federal law.
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What to do
Action · 8 steps
01By July 8-9, 2026: Billing team and clinical staff must attend the applicable provider training webinar (RBHS on July 8, 11am-12:30pm; OSUS-affiliated on July 8, 1-2:30pm; LIP on July 9, 11am-12:30pm) and review the updated provider manuals posted on the SCDHHS website.
02Prior to July 1, 2026: Download and review the complete updated RBHS and LIP provider manuals, focusing on the new Billing Guidance and Benefit Criteria and Limitations sections, updated service definitions, and any ORP requirements if applicable.
03Update internal billing workflows, templates, and compliance checklists to reflect unified service definitions and new billing guidance.
04Ensure all psychiatrists and physicians practicing within RBHS organizations understand new ordering, referring, and prescribing requirements.
05Immediately: Reinforce compliance with SC Code § 44-113-60 and 42 USC § 1320a-7b(b) anti-kickback prohibitions with all staff.
06Review current provider practices to eliminate any kickback or self-referral arrangements.
07For MCO-enrolled members: Confirm all RBHS and behavioral health service authorization and coverage decisions with the member's specific MCO, as MCOs retain responsibility for authorizations and reimbursement.
08Contact the Provider Service Center at (888) 289-0709 with any billing or compliance questions.
If missed: Failure to comply with anti-kickback policies may result in claim denials, administrative penalties, program termination, and criminal referral.
Original notice
Updated Rehabilitative Behavioral Health Services and Licensed Independent Practitioners Provider Manuals
scdhhs.gov · Always check the source before changing claims.