PCP Scorecard and Preventative Services

Access to and quality of care are top priorities for South Dakota Medicaid. To support this goal, South Dakota Medicaid will be sending a Primary Care Provider (PCP) Scorecard to a designated contact at each PCP clinic in September. This scorecard is designed to help clinics and PCPs enhance care quality for Medicaid recipients.

The 2024 scorecard assesses individual clinic performance for calendar year 2023 against specific targets in the following areas:

  • Preventative Visits (Infant, Child, Adolescent, and Adult)
  • Emergency Department Visits (Child and Adult)
  • Colorectal Screenings (Ages 51 to 75)
Preventative Service Rate Increase

Please note that as of July 1, 2024, Medicaid rates for comprehensive preventative visits (CPT codes 99381 – 99397) have been rebased, resulting in an average increase of 39 percent. Updated reimbursement rates can be found on the Physician Services Fee Schedule.

Care management providers are encouraged to reach out to recipients in their caseload who have not had a preventative visit in the past year. Providers can access their caseload information through the Medicaid Portal. Visit the South Dakota Department of Social Services website for more information.