Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
SC Medicaid - SCDHHSMedicaid · Billing Codes · Claims & Billing · SC · Emergency Medicine, PsychiatryHigh impact

Updated Billing Guidance for Hospital-based Crisis Stabilization Services

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

Summary

South Carolina Medicaid has updated billing guidance for hospital-based crisis stabilization services in EmPATH units, eliminating the requirement for separate NPI enrollment and allowing hospitals to use their existing emergency department NPI. New procedure codes S9484 and S9485 with revenue code 919 are now required for billing these services as outpatient hospital add-on services.

Get alerts when payers change rules like this one

We check SC Medicaid - SCDHHS and other payers every day and email you when a change matches your specialty and state.

Get SC Medicaid - SCDHHS alertsPolicy Monitoring is free. No card required.

What to do

by Oct 1, 2025 · 3 steps
01Hospital billing teams with EmPATH or EmPATH-like units must update billing systems to use procedure codes S9484 (brief psychiatric emergency, $38.17/hour) and S9485 (extended psychiatric emergency, $458/day) with revenue code 919 for crisis stabilization services.
02Use existing emergency department NPI instead of obtaining separate enrollment.
03Configure billing system to prevent billing both S9484 and S9485 for the same episode of care and ensure services are processed as add-on services not subject to outpatient hospital multiplier.

Codes mentioned

S9484S9485

Original notice

Updated Billing Guidance for Hospital-based Crisis Stabilization Services
scdhhs.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

SC Medicaid - SCDHHS policiesSC policy changesEmergency MedicinePsychiatryCode S9484Code S9485

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account