Department of Social Services

Medical Services

The effect of the rule changes will be to update citations, update procedure codes that are reimbursed at a percent of the provider’s usual and customary charge and included on the applicable fee schedule, clarify coverage for the removal of implanted contraceptives, clarify coverage for routine foot care services for those diagnosed with metabolic, neurologic, or peripheral vascular diseases, update personal care assessment frequency and the information reviewed, clarify reasons for discontinuation of personal care services, remove the certificate of medical necessity requirement to align with Medicare, increase the timeliness of access to breast pumps by updating billing provisions, update treatment plan timing to coordinate with the mental health chapter and current practice, update and clarify nursing facility level of care definitions, categories, and various coverage for services, clarify what settings and services apply to each level of care classification, clarify and detail the specialized therapy services that are covered under the Family Support 360 waiver program and update the applicable procedure codes for billing those services, and remove repealed rule references.

New content is added below as the draft rules move through the rule-making process.

Interim Rules Hearing
Important Dates
Public Hearing:
Comment Deadline:
Interim Rules Committee Hearing:
Filed-Secretary of State:
Rule Effective:

Agency Contact: Teresa Schulte mail to: DSSAdminRules@STATE.SD.US