Physicians services provider manual

Abstract

The State of South Carolina (South Carolina or State) Medicaid program recognizes professional medical services that are medically necessary, unless limitations are noted within the Other Service Limitations section of this manual. Information in this manual includes South Carolina Medicaid policies for general medical care, such as, office exams. These services are predominantly billed to Medicaid by Primary Care Physicians (PCPs), such as family physicians, internists, general practitioners, obstetricians/gynecologists (OB/GYN) and pediatricians. However, the guidelines are written for all providers rendering services to South Carolina citizens who are Medicaid beneficiaries. This manual lists requirements that must be met in order to qualify for payment from Medicaid.