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South Dakota Medicaid Coverage on Prenatal Visits

The South Dakota Department of Social Services and the South Dakota Department of Health are working to identify pregnant women who may be eligible for programs and services in each agency. In an effort to identify women who are already on Medicaid when they become pregnant early in their pregnancy, the SD Medicaid Program is offering an additional $10 incentive when a provider initiates prenatal care through current procedural terminology (CPT) code 0500F.

The CPT code and corresponding patient information will be included in the update from  South Dakota Medicaid and the Office of Children and Family Services. We encourage providers to report this code as it will allow Medicaid and the Department of Health to provide additional educational materials and case management services if necessary to pregnant women. Providers should submit the claim within 15 days of the initial prenatal visit to help facilitate access to these educational materials and case management services.

Please share this information with your provider and billing teams. The CPT code went live on May 1, so you may begin utilizing that today!

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