General Requirements
These manuals include requirements that are applicable to most or all providers and should be reviewed in addition to claim instructions and provider specific manuals.
Within each manual the keyboard shortcut Ctrl+F (Control Find) will open a search bar allowing you search for specific words or phrases throughout the entire document.
Provider Basics
Care Management Programs
CMS 1500 Claim Instructions
UB04 Claim Instructions
Dental Provider Manuals
Institutional Provider Manuals
Professional Provider Manuals
Pharmacy Services
HCBS Waiver Services
Tracking Log
The administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) requires the United States Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans and employers. South Dakota Medicaid is required by federal law to conform to the national standards. Listed below is a series of manuals detailing the situational data elements and plan-specific values that must be included in transactions that are transmitted electronically to South Dakota Medicaid.
License for Use of Physicians' Current Procedural Terminology (CPT)
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Point and Click License for Use of Current Dental Terminology (CDT™)
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These materials contain Current Dental Terminology (CDT™), Copyright © 2015 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.
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