MedicaidReimbursementMedium impact
Residential Habilitation Service Rate Increases for the Intellectual Disability/Related Disabilities and Head and Spinal Cord Injury Waivers
SC Medicaid - SCDHHS·SC · PM&R (Physical Medicine & Rehab), Neurology·Claims & Billing
Effective date
Nov 1, 2025
We identified it
Jun 18, 2026
Summary
South Carolina DHHS is increasing reimbursement rates for residential habilitation services under Intellectual Disability/Related Disabilities and Head and Spinal Cord Injury waivers effective November 1, 2025. Rate increases range from $0.66 to $89.23 per service across various residential care tiers.
Action Required
By November 1, 2025: Billing team must update Therap billing system and internal fee schedules with new rates for T2016 (with modifiers U1-U8) and T2017 codes. Verify updated rates appear in Therap authorizations starting Nov 1. Continue using old rates on authorizations for dates of service prior to Nov 1. Contact MedicaidWaiver@scdhhs.gov with questions.