MedicaidBilling CodesHigh impact
Updated Billing Guidance for Hospital-based Crisis Stabilization Services
SC Medicaid - SCDHHS·SC · Emergency Medicine, Psychiatry·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 18, 2026
Summary
South Carolina Medicaid has updated billing guidance for hospital-based crisis stabilization services in EmPATH units, eliminating the requirement for separate NPI enrollment and allowing hospitals to use their existing emergency department NPI. New procedure codes S9484 and S9485 with revenue code 919 are now required for billing these services as outpatient hospital add-on services.
Action Required
By October 1, 2025: Hospital billing teams with EmPATH or EmPATH-like units must update billing systems to use procedure codes S9484 (brief psychiatric emergency, $38.17/hour) and S9485 (extended psychiatric emergency, $458/day) with revenue code 919 for crisis stabilization services. Use existing emergency department NPI instead of obtaining separate enrollment. Configure billing system to prevent billing both S9484 and S9485 for the same episode of care and ensure services are processed as add-on services not subject to outpatient hospital multiplier.