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Medical Services

Medical Services Notices

Commission Approves Changes to the Medical Services Provider Manual (PDF) (Posted March 22, 2018)

Commission approves revisions to the Medical Services Provider Manual (MSPM) (PDF) effective September 1, 2017  (Posted August 22, 2017)

Medical Fee Schedule Update 2017 (PDF) - The Commission received a draft of the 2017 Medical Services Provider
Manual (MSPM) at their Business Meeting on July 17, 2017, and is accepting comments on the proposed changes through August 11, 2017. The effective date of the new fee schedule is September 1, 2017 (Posted July 20, 2017)

2016 Medical Services Provider Manual (MSPM) - At the Business Meeting on August 15, 2016, the Commission approved a revision to the Medical Services Provider Manual (MSPM) to reflect 2016 Resource Based Relative Values (RBRVS) issued by the Center for Medicare/Medicaid (CMS) and the American Medical Association's Current Procedural Terminology (CPT) Codes. Included in the approval is a Conversion Factor of $50 and no change to the Maximum Allowable Payments (MAP) for an Independent Medical Examination (IME). The IME fee will remain rated as Individual Consideration. The effective date is September 1, 2016.

Medical Fee Schedule Update 2016 (PDF) - The Commission received a draft of the 2016 Medical Services Provider Manual (MSPM) at their Business Meeting on July 18, 2016, and is accepting comments on the proposed changes through July 29, 2016. The effective date of the new fee schedule is September 1, 2016. (Posted July 19, 2016)

2015 Medical Services Provider Manual (MSPM) (PDF) Compliance Advisory Notice. The 2015 MSPM goes into effect September 1, 2015. It is imperative that providers and carriers obtain the new MSPM to assure compliance. (Posted September 1, 2015)

Commission will adopt the 2015 ICD-10 conversion (PDF) effective October 1, 2015. (Posted August 27, 2015)

2015 Medical Services Provider Manual Advisory Notice (PDF) (Posted August 10, 2015)  

2015 Medical Services Provider Manual pre-order and release date advisory notice (PDF) (Posted June 16, 2015)

Commission changes process for filing Medical Bill Disputes (PDF) . (Posted March 6, 2015)

Updated HCFA 1500 Form (PDF) . After March 31, 2014, healthcare providers will no longer be allowed to submit payment requests under the previous versions of the 1500 form. (Posted March 19, 2014) 

Mandatory Payment Reduction in Medicare Fee-for-Service (FFS) Program. (PDF) This reduction does NOT apply to workers' compensation claims. (Posted April 23, 2013)

Commission amends fee schedule for Ambulatory Surgery Centers surgically implanted devices (PDF) . (Posted April 19, 2013)

Medical Services Division Announces Online Medical Bill Dispute Filing and Resolution Process. The SC Workers' Compensation Medical Services Division is pleased to announce the release of a new online Medical Bill Dispute form to assist users in the filing and resolution of workers' compensation medical billing issues. (Posted April 18, 2012) 

NCCI Proposes Increase for Workers' Compensation Loss Costs in South Carolina (PDF) February 7, 2012

Revision Notice 2010 Medical Services Provider Manual Section 2 Anesthesia (PDF) December 20, 2011

Update on Pass Throughs (PDF) December 22 2009

 

Physician Fee Schedule (Medical Services Provider Manual)

The  Medical Services Provider Manual outlines billing and payment policy for physicians and other health care professionals and provides the current schedule of fees. The fee schedule does not cover hospital charges, general dental, EMS Services, Emergency Air Transportation, or services rendered outside of South Carolina. 

2016 Medical Services Provider Manual (MSPM) - At the Business Meeting on August 15, 2016, the Commission approved a revision to the Medical Services Provider Manual (MSPM) to reflect 2016 Resource Based Relative Values (RBRVS) issued by the Center for Medicare/Medicaid (CMS) and the American Medical Association's Current Procedural Terminology (CPT) Codes. Included in the approval is a Conversion Factor of $50 and no change to the Maximum Allowable Payments (MAP) for an Independent Medical Examination (IME). The IME fee will remain rated as Individual Consideration. The effective date is September 1, 2016.

Medical Fee Schedule Update 2016 (PDF) - The Commission received a draft of the 2016 Medical Services Provider Manual (MSPM) at their Business Meeting on July 18, 2016, and is accepting comments on the proposed changes through July 29, 2016. The effective date of the new fee schedule is September 1, 2016. (Posted July 19, 2016)

Effective September 1, 2015, the 2010 MSPM will no longer govern non-inpatient, non-ASC medical services rendered to Workers' Compensation patients in South Carolina. Please refer to the 2015 Manual Services Provider Manual (PDF) for billing and treatment for services provided after August 31, 2015.

2010 Medical Service Provider Manual Pricing Corrections and Revisions (PDF) Effective January 1, 2013. (Posted April 25, 2013) Click here to view.

Revision Notice 2010 Medical Services Provider Manual, Section 2, ANESTHESIA (PDF) December 20, 2011

Pharmacy Fee Schedule (PDF) Effective December 19, 2011

2010 Medical Services Provider Manual (PDF) effective July 1, 2010

2010 Medical Services Provider Manual Recommendation (PDF) September 18, 2009

 

Hospital and Ambulatory Surgery Center Payment Manual

Commission amends fee schedule for Ambulatory Surgery Centers surgically implanted devices (PDF) . (Posted April 19, 2013)
 
1997 Hospital and Ambulatory Surgery Center Payment Manual (PDF)

DRG Conversions for 1997 Payment Manual,  DRG Updates (PDF)