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SCAM ALERT

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.

 

The South Carolina Department of Health and Human Services (SCDHHS) uses the SolventumTM (formerly 3MTM) All Patient Refined Diagnosis Related Groups (APR-DRGs) classification system as the method of paying for hospital inpatient services provided by general acute care hospitals, including distinct part units of general acute care hospitals, and long-term acute care hospitals.

Effective for inpatient hospital discharges incurred on or after Oct. 1, 2025, SCDHHS updated the APR-DRGs classification system, from version 32 to version 42 of the APR-DRGs. The South Carolina APR DRG payment calculator has been updated to reflect this version change and can be accessed at the link below.

APR DRG Calculator v42

The APR DRG Calculator is provided for illustration purposes only. It does not capture all the editing and pricing complexity of the South Carolina Medicaid Management Information System (MMIS). In cases of differences in calculated payment between the APR DRG Calculator and the South Carolina MMIS, the MMIS claims processing system should be assumed to be correct.

Please note that effective Oct. 1, 2025, the hospital specific per discharge rates of teaching hospitals no longer include the Graduate Medical Education components (Direct and Indirect Medical Education if applicable).