MedicaidReimbursementLow impact
Updates to Adult Day Health Care Service Rates
SC Medicaid - SCDHHS·SC · Geriatrics·Provider Communication
Effective date
Oct 1, 2025
We identified it
Jun 18, 2026
Summary
South Carolina Medicaid is increasing the reimbursement rate for adult day health care services (HCPCS code S5102) from $72 to $80 per day for members in specific HCBS waiver programs. This rate increase applies only to Community Choices, Community Supports, and Intellectual Disability/Related Disabilities waiver participants.
Action Required
By October 1, 2025: Billing team must update fee schedules in billing system to reflect new $80 daily rate for HCPCS code S5102 when billing South Carolina Medicaid for adult day health care services. Verify patient eligibility in specified waiver programs (Community Choices, Community Supports, or Intellectual Disability/Related Disabilities) before applying the increased rate.