How to become a Medicaid provider in South Carolina
To bill South Carolina Medicaid, enroll through SCDHHS online Provider Enrollment web application. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- SCDHHS online Provider Enrollment web application
- Steps
- 6
- Documents
- 6
- Plans listed
- 5
On this page
South Carolina Medicaid enrollment at a glance
To bill South Carolina Medicaid, enroll through SCDHHS online Provider Enrollment web application. The process has 6 steps, listed below with the documents the state asks for.
- Program
- Healthy Connections Medicaid (South Carolina Department of Health and Human Services, SCDHHS)
- Enrollment portal
- SCDHHS online Provider Enrollment web application
- Application fee
- Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. SCDHHS's enrollment page does not list a separate state fee.
- Fingerprinting
- High-risk providers must submit fingerprints and/or have a physical site visit. If fingerprinting runs past the 30-day revalidation deadline, sending a copy of the fingerprint appointment confirmation with the other documents prevents termination. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.
- Site visit
- SCDHHS screening includes site visits where applicable, and high-risk providers may get a physical site visit at revalidation. Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections.
- Revalidation
- Since June 1, 2026, high-risk providers (federal or state-designated) revalidate every year and all others every three years, more often than the federal minimum. Under a CMS-approved two-year strategy, everyone first enrolled before June 1, 2025 will be revalidated. A rapid cohort covers opioid treatment programs, DME, home health, hospice, nursing facilities, private RBHS, independent licensed behavioral health practitioners, BCBAs/BCaBAs and HCBS providers. Wait for a notification letter with a revalidation number, then submit online within 30 days. Missing the deadline counts as voluntary termination.
- Provider manual
- Provider manual
Steps
- Make sure you meet SC licensure or certification requirements and have an NPI
- Start the online enrollment application. A Reference ID is issued; submit within 30 days or the draft is purged
- Fax supporting documents to Provider Enrollment (803-870-9022) with the Reference ID
- E-sign the provider enrollment agreement, which covers the participation agreement, EFT agreement, W-9 and trading partner agreement
- Sign any additional contract your provider type needs, and complete screening (licensure verification and site visit if applicable)
- After the official enrollment notice, contract with each MCO; each runs its own provider enrollment
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- SCDHHS contracts with five MCOs, and each runs its own provider enrollment, reimbursement and authorization. Providers credential with each plan separately; SCDHHS describes no centralized credentialing. The enrollment broker offers managed care enrollment training (providertrainings@maximus.com).
- Plans (state list)
- Absolute Total Care
- BlueChoice (Healthy Blue)
- Humana Healthy Horizons
- Molina
- Select Health (First Choice)
Frequently asked questions
How do I become a Medicaid provider in South Carolina?
To bill South Carolina Medicaid, enroll through SCDHHS online Provider Enrollment web application. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in South Carolina Medicaid?
Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. SCDHHS's enrollment page does not list a separate state fee.
How often must South Carolina Medicaid providers revalidate?
Since June 1, 2026, high-risk providers (federal or state-designated) revalidate every year and all others every three years, more often than the federal minimum. Under a CMS-approved two-year strategy, everyone first enrolled before June 1, 2025 will be revalidated. A rapid cohort covers opioid treatment programs, DME, home health, hospice, nursing facilities, private RBHS, independent licensed behavioral health practitioners, BCBAs/BCaBAs and HCBS providers. Wait for a notification letter with a revalidation number, then submit online within 30 days. Missing the deadline counts as voluntary termination.