Medical Services Division
The Medical Services Division establishes and monitors billing and payment policies for medical services rendered to workers' compensation claimants and publishes the Medical Services Provider Manual.  Division personnel are available Monday through Friday from 8:00 a.m. to 4:30 p.m. to answer questions pertaining to medical billing and payment policy.

Injured workers who have concerns about their medical care should contact the Claims Department at 803-737-5723.

Mandatory Payment Reduction in Medicare Fee-for-Service (FFS) Program. This reduction does NOT apply to workers' compensation claims. Read more...

Medical Services Division Advisory Statement - Effective January 1, 2013
Billing and Payment of Professional Fee Revenue Codes 960 through 999


Medical Bill Dispute Resolution Process
Click here for instructions on filing and resolution of medical billing issues. Please note that submittal of a dispute form must follow proper process and incomplete submittals will not be considered.

2010 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 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.

Copies of the manual may be purchased for $75.00 by sending a check payable to the South Carolina Workers' Compensation Commission at the following address:

S. C. Workers' Compensation Commission
Attn: Medical Services
P. O. Box 1715
Columbia, SC 29202-1715

Click the following link for a brochure and order form.
2010 Medical Services Provider Manual 

Revision Notices

2010 Medical Services Provider Manual Pricing Corrections
and Revisions Effective January 1, 2013

2010 Medical Services Provider Manual, Section 2, ANESTHESIA

 Pharmacy Fee Schedule Effective December 19, 2011

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. 

Click the links below to download a PDF version of the 2006 or 1997 Hospital and Ambulatory Surgery Center Payment Manuals:

•  Inpatient Hospital

Claims for inpatient hospital stays are paid according to a payment system based on diagnosis related groups (DRGs).  DRG is a system of classifying an inpatient stay based on the patient’s diagnosis, medical condition and any procedures performed.  Payments are hospital-specific to account for factors such as rural/urban, number of indigent patients, teaching hospital, etc.

• Outpatient Hospital

Claims for outpatient services rendered at a hospital are paid based on grouping outpatient services into ambulatory payment classifications (APCs). Services within an APC are similar clinically and require comparable resources. Each APC is assigned a relative payment rate based on the median cost of the services within that classification.   

• Ambulatory Surgical Center