MedicaidAdministrativeHigh impact
Medicaid Ordering, Referring and Prescribing (ORP) Providers Update
SC Medicaid - SCDHHS·SC·Enrollment
Effective date
Jul 1, 2026
We identified it
Jun 18, 2026
Summary
Starting July 1, 2026, South Carolina Medicaid will reject claims that don't include the National Provider Identifier (NPI) of physicians who ordered or referred services. All providers who order, refer, or prescribe services for Medicaid members must enroll with SCDHHS as ORP providers, even if they don't submit claims directly.
Action Required
By July 1, 2026: All providers who order or refer services for South Carolina Medicaid patients must enroll as ORP providers at the SCDHHS enrollment website. Billing team must ensure all claims include the ordering/referring physician's NPI. Medical residents and interns must use the 'Ordering/Referring' enrollment type specifically. Register for virtual training sessions available May-July 2026 at www.medicaidelearning.com or call (888) 289-0709. Claims without proper ORP provider information will be rejected and denied payment.