South Dakota Medicaid is implementing inflationary rate increases effective July 1, 2024 for services provided in State Fiscal Year 2025. Updated fee schedules are available online on the Department of Social Services (DSS) website. Rate increases include significant increases to primary care services (CPT codes 99202 – 99215) and preventative care services (CPT codes 99381 – 99397). There are also some rates that are being rebased or remaining the same as they are already at or above their target methodology (typically 90% allowable Medicare rate).
Any services otherwise not subject to a targeted increase or rate rebase are receiving a 4.0% inflationary increase. South Dakota Medicaid providers should continue to submit claims and bill South Dakota Medicaid as they did prior to the July 1, 2024 rate changes.
Please review the DSS memo or visit the DSS website to estimate how this may impact your organization. If you have any questions, comments, or concerns, please reach out to Jacob Parsons, SDAHO’s Director of Advocacy and Reimbursement.
