Friday, May 14, 2021
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South Dakota Medicaid Updates COVID-19 FAQ

​South Dakota Medicaid has updated the COVID-19 Frequently Asked Questions (FAQ) document to reflect clarifying information about bill for testing and treatment of COVID-19 and pharmacist reimbursement for COVID-19 testing and vaccine administration. South Dakota Medicaid noted the diagnosis codes accepted on claims related to COVID-19 testing and treatment. One of the designated COVID-19 diagnosis codes must be present on the claim to exempt the claim from cost sharing. Medicaid also clarified reimbursement provisions for monoclonal antibody therapy in accordance with Medicare guidelines.

South Dakota Medicaid also updated the FAQ with information on reimbursement for COVID-19 testing and vaccine administration by pharmacists, pharmacy interns, and pharmacy technicians. South Dakota Medicaid will reimburse pharmacy providers through the Pharmacy Point of Sale System (POS) for the administration of COVID-19 vaccines for South Dakota Medicaid recipients. COVID-19 vaccine administration claims should not be billed on a CMS 1500. This change impacts COVID-19 vaccinations only; all other vaccines as well as COVID-19 tests should continue to be billed on the CMS 1500 claim form.

The bulletin from South Dakota Medicaid regarding the updates to the FAQ is available here

The full COVID-19 FAQ is available on the Department of Social Services website.

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