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Healthy Connections Medicaid team members and managed care plans will never ask for money, gift cards or something else of monetary value via text, email or a phone call. If someone contacts you asking for something of monetary value to get or keep Medicaid coverage, please report it by contacting the Medicaid fraud hotline at (888) 364-3224 Monday through Friday from 8:30 a.m. to 5 p.m. or by sending an email to FraudRes@scdhhs.gov.

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Updates to Adult Day Health Care Service Rates

Updates to Adult Day Health Care Service Rates

MB#
25-027

The South Carolina Department of Health and Human Services (SCDHHS) will increase the reimbursement rate for the adult day health care (ADHC) service provided to certain South Carolina Healthy Connections Medicaid members who participate in home and community-based services (HCBS) waiver programs operated by SCDHHS and the South Carolina Department of Behavioral Health and Developmental Disabilities’ Office of Intellectual and Developmental Disabilities. 

Effective for dates of service on or after Oct. 1, 2025, the reimbursement rate for ADHC services billed using Healthcare Common Procedure Coding System (HCPCS) code S5102 will increase from $72 to $80 per day. The reimbursement rate will be updated in the HCBS Waiver Fee Schedule available on SCDHHS' website by Oct. 1, 2025.

The rate increase for HCPCS code S5102 is limited to services rendered to Healthy Connections Medicaid members who participate in the following waiver programs:

  • Community Choices
  • Community Supports
  • Intellectual Disability/Related Disabilities 

Providers should direct any questions related to this bulletin to the Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operation are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. You can also email MedicaidWaiver@scdhhs.gov.

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