Rate Updates for State Plan Services and Home and Community-based Services

The South Carolina Department of Health and Human Services (SCDHHS) issued Medicaid Bulletin MB# 26-044 on October 30, 2026, announcing reimbursement rate increases for certain state plan services and home and community-based services (HCBS) provided through the state's 1915(c) waiver programs. The increases take effect for dates of service on or after December 1, 2026. For state plan services billed to Healthy Connections Medicaid members, three service categories receive rate increases: children's personal care (T1019) increases from $25/hour to $26/hour; enhanced nursing services (T1002) increases from $50/hour to $51/hour; and nursing services (S9123) increases from $47/hour to $48/hour. For HCBS waiver services, residential habilitation (T2016) under the ID/RD and HASCI waivers receives rate increases across eight modifier levels, ranging from a new rate of $93.28 (modifier U1, formerly $91.76) to $552.09 (modifiers U7 and U8, formerly $536.86). Residential habilitation billed as T2017 increases from $21.49 to $22.06 per 15-minute unit. Personal care services (T1019) under the CC, CS, HIV/AIDS, ID/RD, and VENT waivers increase from $25/hour to $26/hour. Nursing services (S9123) under the HASCI, HIV/AIDS, ID/RD, and VENT waivers increase from $47/hour to $48/hour. SCDHHS states that the updated rates will be reflected in all related billing systems and the HCBS Waiver Fee Schedule by December 1, 2026. Claims billed for dates of service prior to December 1, 2026, are processed at the rates in effect for those dates.