SD DSS Releases Memorandum on Provider Inflationary Increases

South Dakota Department of Social Services (DSS) releases memorandum on provider inflationary increases. Senate Bill 191, the General Appropriations Act, provides the following increases effective for April 1, 2019 dates of service and ongoing in FY2019. 

1.5 percent increase for Medicaid providers including:

  • Hospitals
  • Physicians
  • Dentist
  • Optometrists/Ophthalmologist
  • DME (except CPTs subject to the federal Upper Payment Limit)

4 percent increase for other targeted services including:

  • Community Mental Health Centers
  • Substance Use Disorder Agencies
  • Personal Care Services
  • Child Private Duty Nursing
  • Select In-Home Services:
    • CPT S9123
    • CPT S9122
    • CPT S9124
  • Select Outpatient Psychiatric:
    • CPT 90791
    • CPT 90832
    • CPT 90837
  • Select Emergency Transportation:
    • CPT A0429
    • CPT A0430
    • CPT A0431

6.5 percent increase for Community Support Providers (Developmental Disability)

10 percent increase for Nursing Homes

South Dakota Medicaid has revised the fee schedules and updated the fee schedules with rates effective April 1, 2019. The fee schedules are available online.

In addition to the above changes, South Dakota Medicaid has added CPT codes A0426 and A0428 to the transportation fee schedule. Please be advised that non-emergent ground ambulance claims with a date of service of April 1, 2019 or later must be submitted using procedure code A0426, ALS non-emergency, or A0428, BLS non-emergency, as applicable. Non-emergent ground ambulance services must not be billed using A0427 or A0429.

Information regarding when non-emergent ground ambulance services are covered is provided in the Ground Ambulance provider manual, which is available on the DSS website. The Ground Ambulance manual was recently updated to a standalone manual as part of provider manual update project.

If you have any questions, please contact the Division of Medical Services at 1-800-452-7691.