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Medical Services Provider Manual

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 fee schedule does not cover hospital charges, general dental, or services rendered outside of South Carolina.

At the August 21, 2017 business meeting, the Commission approved a revision to the MSPM to reflect 2017 Resource Based Relative Values (RBRVS) issued by the Center for Medicare/Medicaid (CMS) and the American Medical Association's current Procedural Terminology (CPT) Codes. The effective date is September 1, 2017.  

Click the following link for information on how to purchase the 2017 Medical Services Provider Manual. It is imperative that providers and carriers obtain the 2017 MSPM to assure compliance.

2017 Medical Services Provider Manual

2016 Medical Services Provider Manual

 

Updated HCFA 1500 Form
Beginning January 1, 2014, health care providers were able to submit medical payment requests using the revised 1500 form. After March 31, 2014, healthcare providers will no longer be allowed to submit payment requests under the previous versions of the 1500 form. Read more...