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SC Medicaid - SCDHHSMedicaid · Billing Codes · Medical Policy · SC · Nephrology, Dentistry, PsychiatryMedium impact

Updates to Clinic Services Manual

Act
by Nov 2, 2026
Effective date
Dec 1, 2026
Identified
Oct 7, 2026

Summary

The South Carolina Department of Health and Human Services (SCDHHS) is updating the Clinic Services Manual effective December 1, 2026, with clarified service definitions, clinical criteria, and billing guidelines for opioid treatment programs, dental services in ambulatory surgical centers, End-Stage Renal Disease clinics, dialysis services, and in-home dialysis. Providers must review the draft manual and can submit feedback by November 2, 2026, with educational webinars scheduled for November 12 and December 8, 2026.

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What to do

by Nov 2, 2026 · 4 steps
01Billing team and clinical staff should review the draft Clinic Services Manual (available at the SCDHHS website) and submit feedback to MedicaidStatePlan@scdhhs.gov regarding the updated billing guidance for opioid treatment programs, dental services in ambulatory surgical centers, End-Stage Renal Disease clinics, dialysis services, and in-home dialysis.
02Before December 1, 2026: Attend at least one of the two live webinars (November 12, 2026, 1-2 p.m. or December 8, 2026, 10-11 a.m.) to understand the manual updates, or review the recorded webinars posted on the SCDHHS Provider Training Resources page.
03By December 1, 2026: Update billing workflows, templates, and coding documentation in your practice management system to align with the finalized Clinic Services Manual updates, particularly for claims involving dialysis, renal disease, and opioid treatment services.
04Contact the Provider Service Center at (888) 289-0709 or https://www.scdhhs.gov/providers/contact-provider-representative for clarification on specific billing scenarios.

Original notice

Updates to Clinic Services Manual
scdhhs.gov · Always check the source before changing claims.
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Related policy hubs

SC Medicaid - SCDHHS policiesSC policy changesNephrologyDentistryPsychiatry

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