Provider Reimbursements and Audits

Provider Reimbursement and Audits works with various programs within the Department of Social Services to establish reimbursement methodology and reimbursement rates.

This may include programs for:

• Hospitals
• Rural Health Clinics
• Medical Providers
• Group and Residential Treatment Facilities

We also provide auditing services for the Department. For those providers who have elected to participate in the Department's programs, the office is responsible for the verification of the provider's program costs and for compliance with the established reimbursement requirements.

Other Information

• Disproportionate Share Hospital (DSH) 2025 Survey
• Hospital Statement of Cost - Catastrophic County Poor Relief Program
• Cost Reporting
• Rate Workgroups

Provider Services Rate Review Cycles

The following items are reviewed using a tentative schedule pursuant to SDCL 28-22. Inclusion on this list does not indicate a statutory requirement for review. Items not mandated by statute are included to enhance transparency related to provider reimbursement methodologies. For more information on the rate review cycles please visit the Rate Workgroups page.

Service	FY23	FY24	FY25	FY26	FY27	FY28	FY29
Inpatient Hospital Services
Outpatient Hospital Services
Ambulatory Surgical Centers
Federally Qualified Health Centers and Rural Health Centers
Psychiatric and Intensive Residential Services
Substance Use Disorder Services
Mental Health Services Community and Independent
Behavioral Health Prevention Services
Criminal Justice/Juvenile Justice Initiative
Dental Services

Updated January 1, 2026