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SC Medicaid - SCDHHSMedicaid · Reimbursement · Provider Communication · SC · GeriatricsLow impact

Updates to Adult Day Health Care Service Rates

Act
by Oct 1, 2025
Effective date
Oct 1, 2025
Identified
Jun 18, 2026

Summary

South Carolina Medicaid is increasing the reimbursement rate for adult day health care services (HCPCS code S5102) from $72 to $80 per day for members in specific HCBS waiver programs. This rate increase applies only to Community Choices, Community Supports, and Intellectual Disability/Related Disabilities waiver participants.

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What to do

by Oct 1, 2025 · 2 steps
01Billing team must update fee schedules in billing system to reflect new $80 daily rate for HCPCS code S5102 when billing South Carolina Medicaid for adult day health care services.
02Verify patient eligibility in specified waiver programs (Community Choices, Community Supports, or Intellectual Disability/Related Disabilities) before applying the increased rate.

Codes mentioned

S5102

Original notice

Updates to Adult Day Health Care Service Rates
scdhhs.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

SC Medicaid - SCDHHS policiesSC policy changesGeriatricsCode S5102

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