The Official Web Site of the State of South Carolina

In response to stakeholder comments, the Commission promulgated an amendment to S.C. Code Ann. Regs. 67-610 that amends the existing process by which litigants before the Commission amend pleadings and add or remove parties to a claim. The amended regulation has been approved by the legislature and is effective May 26, 2023. The full advisory may be accessed here.

 

The Commission will conduct the monthly business meeting June 5, 2023 at 10:30am in Hearing Room A at the Commission offices in Columbia. Participants may access the meeting online. The agenda and zoom link may be accessed here.

 

 

 

Medical Fee Schedules

Medical Services Provider Manual (MSPM)

Any appropriately licensed medical provider who is authorized by the employer or insurance carrier may treat workers' compensation claimants. The Medical Services Provider Manual (MSPM) outlines billing and payment policy for physicians and other health care professionals and provides the current schedule of fees. The MSPM does not cover hospital charges, general dental, or services rendered outside of South Carolina.

At the Business Meeting on March 13, 2023, the Commission approved the Conversion Factor of $51.50 for professional services and approved the Anesthesia Conversion factor of $32.85. The changes also include adopting the 20323 CMS CPT/HCPS codes. 

The effective date of the updated MSPM is April 1, 2023.

Click the following link for information on how to purchase the 2023 Medical Services Provider Manual. It is imperative that providers and carriers obtain the 2023 MSPM to assure compliance.

2020-2023 Medical Service Provider Manuals

 

2006 Hospital and Ambulatory Surgical Center Payment Manual

The Hospital and Ambulatory Surgery Center Payment Manual describes the billing and payment policy for inpatient hospital stays and outpatient services rendered at a hospital or ambulatory surgical center. Effective October 1, 2006, healthcare facilities will be paid 40% more than the federal Medicare program pays for inpatient and outpatient services. 2006 Hospital and Ambulatory Surgical Center Payment Manual (PDF) Hospital and Ambulatory Payment Manual is updated quarterly as Medicare updates policies and pricing. The links below offer additional information regarding the inpatient prospective payment system, outpatient prospective payment system, and ambulatory surgery centers.

Inpatient Hospital

Outpatient Hospital

Ambulatory Surgery Center

 

**Medical Services Division Advisory Statement**

Effective January 1, 2013 - Billing and Payment of Professional Fee Revenue Codes 960 through 999 (PDF)

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