MedicaidReimbursementHigh impact
Rehabilitative Behavioral Health and Substance Use Services Rate Increases
SC Medicaid - SCDHHS·SC · Psychiatry·Claims & Billing
Effective date
Dec 1, 2025
We identified it
Jun 18, 2026
Summary
South Carolina Medicaid has implemented significant rate increases and billing unit changes for behavioral health and substance use services effective December 1, 2025. Key changes include converting H0002 from 15-minute units to encounters, H0032 from 15-minute to 30-minute encounters, correcting H0038 peer support rates to $14.48, and updating reimbursement rates across multiple procedure codes for RBHS providers, LIPs, and substance use services.
Action Required
Immediately: Billing teams in South Carolina must update fee schedules and billing systems to reflect new rates effective December 1, 2025. Update H0002 billing from 15-minute units to encounters, H0032 from 15-minute to 30-minute encounters with 6 encounters per 12 months limit, and H0002 encounter limit to one per day. Correct H0038 individual peer support rate to $14.48 per unit. Download updated RBHS and LIP fee schedules from SCDHHS website. Verify all behavioral health and substance use service rates match new fee schedules to ensure proper reimbursement.