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Medicaid Provider Communication

South Dakota Medicaid utilizes multiple resources to communicate information about initiatives, policy changes, and program updates to enrolled providers. Recent communications are listed here. To ensure you receive future communication, join the Division of Medical Services listserv.

Note: Not all communications are sent via the listserv. In some cases, targeted communication is sent directly to a specific provider group/taxonomy type.  Once communication has been sent out, the communication will be added to the South Dakota Medicaid Provider Bulletins list.

2024 Provider Communication

November High Index Lenses
October Inpatient Hospital Services Manual
September Fall Provider Newsletter
Primary Care Provider Scorecard and Preventative Services
July Update to Medicaid Cost Sharing Requirements
June July 1, 2024 Fee Schedules
May Spring Provider Newsletter
Substance Use Disorder Treatment Services Provided in an Institutions for Mental Disease
Chief Medical Officer Quarterly Updates
March Not Otherwise Classified Codes, Supplies Refills and Physician Administered Drugs Billing Updates
Pregnancy Related Coverage, Reimbursement and Billing Updates
Community and Secure Transportation Services
Update Electronic Data Interchange (EDI) Transactions
February Medicaid Beneficiary Eligibility and Enrollment System (BEES)
Therapy Assistant Billing Guidance
Urgent Care Bulletin
Pregnancy Program Provider Enrollment
January Substance Use Disorder Treatment Outcome Tools
Cognitive Assessment and Care Planning

2023 Provider Communication

December Updated Documentation Guidance
Paper Appeals
Discontinuing the Use of Certificates of Medical Necessity
Changes to Community Health Worker Orders
Chief Medicaid Officer Monthly Updates
Continuous Glucose Monitor Coverage and Billing Changes
November Winter Provider Newsletter
Pregnancy-Related Changes and Eligibility Reminders
Important Vaccine Updates
October Vaccinations Cost Sharing
Preventive Services Coverage Changes
September Medicaid Expansion Claims
Dental Anesthesia
Federal Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) Stand-Alone Vaccine Visit Reimbursement
Balance Billing and Billing Medicaid Recipients
Summer Provider Newsletter
July 30-Month Well-Child Visits
Medicaid Expansion and Professional Claims
Authorized Representatives and Medicaid Applications
Back to School and Well-Child Visits
Primary Care Providers (PCPs) Per Member Per Month Payments
June July 1, 2023 Fee Schedules
Continuous Glucose Monitors and Supplies Coding and Claims
Spring Provider Newsletter
Medicaid Expansion Eligibility and Coverage Start
Community Health Worker Diagnosis Codes
May Expiration of COVID-19 Public Health Emergency
Health Status Report Now Available
Indian Health Service (IHS) Servicing Provider Referrals and Cost-Shares
Payment Error Rate Measurement Reporting Year 2024
Medicaid Expansion Webinars
Public Health Emergency Unwinding Changes to Coverage
April Pre-Admission Screening and Resident Review (PASRR) 1135 Waiver Termination Notice
Developmental Screenings
Claim Documentation
February Important Changes Coming Soon to Medicaid Eligibility
Updated Provider Enrollment Claim Submission Extension
Winter Provider Newsletter
Community Health Worker (CHW) Agency Billing
Ambulatory Payment Classification (APC) Ratio of Cost to Charge and Fee Schedule
January Well-Child Visit Reimbursable Services
ePA for Pharmacy Claims

2022 Provider Communication

December Narrow Therapeutic Index
Grant Fund Opportunity
November Fall Provider Newsletter
Tribal Services Manager
Money Follows the Person
November 2022 Payroll Changes
October Extra Payroll
September New Data Sources for South Dakota Health Link
Dental Services Update
Independent Mental Health Practitioner Administrative Rule Change
Podiatric Services Administrative Rule Change
August Community Health Worker Resources and Tools
Summer Provider Newsletter
July Reducing an Unprecedented Rise in Syphilis Rates
PCP Provider Scorecard and Provider Resources
Extra Payroll
July 1, 2022 Fee Schedules
June Provider Enrollment Claim Submission Extension
May Development Screening
Indian Health Service (IHS) Servicing Providers Licensure and Referrals
Behavioral Health Materials Information
Spring Provider Newsletter
Initial Prenatal Visit Reporting
March Metabolic Screening and Behavioral Health
February Winter Provider Newsletter

2021 Provider Communication

December Driver and Traffic Violation Disclosure Requirements
November Provider News Fall 2021
October Chiropractor Coverage and Billing Requirements
September Federal PDMP Requirements for Prescribers
Primary Care Providers and Oral Health
August Flu Vaccines
Prescription Drug Monitoring Program Requirements
July Provider News Summer 2021
Well-Child Provider Scorecard and Resources
Telemedicine and Telephonic Services Updates
June Provider News Spring 2021
Dispensing Fee Increase
May Provider Enrollment (PE) Portal & Revalidation
April Online Provider Selection Tool for the PCP and HH Programs
COVID-19 FAQ Updates
March Provider Enrollment Portal Accounts
COVID-19 FAQ Updates
February Pharmacy Administered COVID-19 Vaccines Instructions
CHART Bulletin
January COVID-19 FAQ Updates

2020 Provider Communication

December Provider Enrollment Data Access
Fall 2020 Provider Newsletter
Provider Bulletin: COVID-19 Vaccination
90 Day Fill
November APPs Eligible for PCP Program
Provider Bulletin COVID-19 FAQ Update November 2020
UB-04 Claim Submission on the Medicaid Portal
September Provider Bulletin FAQ Update September 14, 2020
August Provider Bulletin HHS PRF How to Guide
HHS Medicaid Provider Relief Fund - Eligible Providers and Extended Application Deadline
Summer 2020 Provider Newsletter
July HHS Medicaid Provider Relief Fund Webinar
HHS PRF Extended Deadline
June FY21 Fee Schedules
Provider Bulletin: Special Payroll June 29th, 2020
Provider Bulletin: COVID-19 FAQ Updates
Provider Bulletin: HHS Announcement
Spring 2020 Provider Newsletter
May Executive Order 2020-26 Medicaid Flexibilities
Hospice Provider Manual
Coronavirus (COVID-19) Frequently Asked Questions
COVID-19 Telehealth Updates
April Coverage of COVID-19 Testing and Treatment for the Uninsured
Medicaid Postpartum Coverage and Elective Postpartum Procedures
COVID-19 Out of State Transfer Prior Authorization Process
Ensure Continued Prompt Payment of Claims
Changes to Silver Diamine Fluoride (D1354) Criteria
March IHS High Dollar Prescriptions
1135 Waiver CMS Approval March 29, 2020
1135 Waiver CMS Approval March 26, 2020
1135 Waiver Submission
SD Medicaid Communications
IHS Contracted Services Telemedicine Claims
Winter 2019 Provider Newsletter
Coronavirus (COVID-19) Frequently Asked Questions
South Dakota Medicaid Office Closure March 16 – March 20
Paper Communication Requests and Reviews (Appeals)
February Anesthesia Manual
Definitive Drug Testing CPT Codes
January Updated Incontinence Supplies Service Limit
Service Limit Inquiry on the Medicaid Portal

 

South Dakota Medicaid Provider Training

Health Status Report Training

Recording | User Guide

Online Selection Tool Training

Recording | PowerPoint

Health Home Training Tools | Sharing Sessions

2024 Sharing Sessions were held in September 2024

2023 Sharing Sessions were held in September and October of 2023.

2022 Sharing Sessions were held in September of 2022.

2021 Sharing Session was held virtually on August 10, 2021.

Heath Home | Quality Assurance Training

2023 Quality Review PowerPoint | Recording | Review
2022 Health Home Quality Review PowerPoint
2022 Quality Assurance Review PowerPoint | Recording | Review Guidance
2022 Tier Update Training Recording
2021 Quality Review PowerPoint | Recording

License for Use of Physicians' Current Procedural Terminology (CPT)

End User Point and Click Agreement

Current Procedural Terminology (CPT) codes, descriptions and other data only are copyright 2015 American Medical Association (AMA).
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.


Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 North State Street, Chicago, IL 60610. Applications are available on the AMA website, https://www.ama-assn.org/practice-management/cpt/ama-cpt-licensing-overview

Applicable FARS/DFARS restrictions apply to government use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-l(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

AMA Disclaimer of Warranties and Liabilities
CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

CMS Disclaimer
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

Should the foregoing terms and conditions be acceptable to you, indicate your agreement and acceptance by clicking on the button labeled "I ACCEPT."

Point and Click License for Use of Current Dental Terminology (CDT™)
End User License Agreement

These materials contain Current Dental Terminology (CDT™), Copyright © 2015 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING ON THE BUTTON LABELED “I ACCEPT,” YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK ON THE BUTTON LABELED “I DO NOT ACCEPT” AND EXIT FROM THIS COMPUTER SCREEN.

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  1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials
  2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association website: http://www.ADA.org/.
  3. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. This product includes Current Dental Terminology ("CDT'"), which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Dental Association, 211 East Chicago Avenue, Chicago, Illinois, 60611. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-l(a) (June 1995) and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements
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