SC Medicaid Provider Enrollment: The 2026 Guide for Practices

You’re here for one of three reasons. A new provider starts next month and still isn’t enrolled. Your application has been sitting in the SCDHHS portal for weeks with no answer. Or a revalidation letter arrived with a deadline printed on it. SC Medicaid provider enrollment covers all three, and the rules changed twice this year.

The South Carolina Department of Health and Human Services runs the program as Healthy Connections Medicaid. SCDHHS processes enrollment applications in 30 business days from the date it receives them. Your enrollment date can backdate up to 90 days before that receipt date, which decides how much of your already-rendered care you can still bill.

Two policy changes in 2026 rewrote what happens after approval. One raised how often you revalidate. The other started rejecting claims that used to pay without a single change on your end.

SC Medicaid Provider Enrollment at a Glance

One O Seven RCM handles state Medicaid enrollment and the billing that follows for practices across all 50 states.

Three 2026 Changes That Affect SC Medicaid Providers

Three SCDHHS policy changes landed this year, and each one touches SC Medicaid provider enrollment. None was phased in. None was optional. Each carries an effective date, and each changes something your billing team already does every week.

The revalidation change carries the shortest fuse. Providers in the 2026 rapid cohort get 30 days from the date printed on their notification letter, and SCDHHS treats a missed deadline as a voluntary termination.

What Is SC Medicaid Provider Enrollment?

SC Medicaid provider enrollment is the process of registering with SCDHHS so you can bill, order, refer, or prescribe for Healthy Connections Medicaid members. Federal law requires enrollment before you participate in the program. Approval gives you a Medicaid provider number tied to your NPI.

SCDHHS screens every application, verifies your licensure, and schedules a site visit when your provider type calls for one. The agency notifies you in writing once your file clears.

Enrollment and Credentialing Are Not the Same Thing

Two different parties run two different processes, in a fixed order, and practices lose months by treating them as one job.

Enrollment registers you with the state. SCDHHS reviews your file and issues your Medicaid ID. That ID lets you bill the state under fee-for-service.

Credentialing is what each managed care organization does before it adds you to its network. SCDHHS doesn’t credential you for the MCOs. The MCOs won’t open their review until the state confirms your enrollment.

You can hold an active Medicaid ID and still have no way to bill a managed care member. That gap catches practices that treat state approval as the finish line and start scheduling.

BlueCross BlueShield of South Carolina tells providers to wait until the Medicaid ID number is in hand before opening an application for a practitioner or group. Run both tracks at once and the MCO sends your file back. For the payer-by-payer version of this sequence, see provider enrollment explained.

Who Has to Enroll With SC Medicaid

SC Medicaid provider enrollment reaches further than the clinicians who submit claims. Three groups have to file, and two of them get missed.

Individual and Organizational Providers

Individual clinicians enroll under a Type 1 NPI. Organizations enroll under a Type 2 NPI as the billing entity. A group needs both, because the entity and each rendering clinician carry separate enrollments that then have to be linked.

Ordering, Referring, and Prescribing (ORP) Providers

Anyone who orders, refers, or prescribes for a Healthy Connections Medicaid member must enroll with SCDHHS, even if they never submit a claim. Per SCDHHS ORP provider guidance, federal law at 42 CFR 455.410(b) drives the requirement.

Select the Ordering/Referring provider type when you enroll. Per the SCDHHS ORP enrollment bulletin, providers enrolling only as Ordering/Referring don’t need to contract with the state’s managed care organizations.

That same bulletin closes a loop that generates duplicate applications. Providers already enrolled in Healthy Connections Medicaid who submit claims don’t need a separate ORP-only enrollment. You already hold what the rule asks for.

One trap sits on the other side. An ORP-only Medicaid ID can’t serve as a billing provider ID. SCDHHS has said claim edits will block payment when an ordering or referring provider submits their NPI in the billing provider field.

Out-of-State Providers, Residents, and Interns

Enrollment in another state’s Medicaid program doesn’t carry over. You file a separate South Carolina application, under South Carolina screening rules, on South Carolina timelines.

Residents and interns can’t complete a full enrollment under current SC policy. They enroll through the Ordering/Referring type instead. You can order and refer with that ID. You can’t render or bill with it, and teaching practices need that mapped before the first claim drops.

Where to Apply: The Two SC Medicaid Portals

South Carolina runs two provider-facing portals with names close enough to confuse anyone. Your staff will land on the wrong one and conclude the system is broken.

Enrollment happens on the first one. Day-to-day billing happens on the second. They use separate credentials, so the login that opens one won’t open the other. The SCDHHS Provider Enrollment portal is where every application, ORP registration, and revalidation starts.

One small rule saves a support call on the SC Medicaid Web Tool. Three failed login attempts lock the user ID for 30 minutes, and the lock clears on its own after that. No one needs to phone anyone.

How SC Medicaid Provider Enrollment Works, Step by Step

SCDHHS runs the whole application online, with one document handoff by fax. Per SCDHHS Become a Provider, the sequence runs like this.

1. Go to providerservices.scdhhs.gov and select Begin a New Enrollment.
2. Choose your enrollment type. Picking the wrong one is the most common cause of rejection, and correcting it means starting the application over.
3. Enter the minimum required information to receive your Reference ID number.
4. Complete the application: NPI, taxonomy code, ownership disclosures, practice locations, and your EFT and W-9 details.
5. Accept the terms by electronic signature, which covers the participation agreement, the EFT agreement, the W-9, and the Trading Partner Agreement.
6. Fax your supporting documentation to (803) 870-9022 with the Reference ID number on every page.
7. Watch for a notice if your provider type requires a Contractual Agreement on top of the Provider Enrollment Agreement.

The Reference ID and the 30-Day Window

Once SCDHHS issues your Reference ID, you have 30 days to submit the application. Miss that window and the agency purges the in-process file rather than holding it, so you restart from an empty form with a new Reference ID.

Someone opens the application, hits a missing malpractice certificate or a DEA copy, sets the file aside to chase the document, and never gets a warning that the clock ran out. The restart also resets your receipt date, which pushes the 90-day backdating window forward and costs you billable services.

Collect the documents before you open the portal.

If you’ve lost a Reference ID once already, the gap sits in document collection. Our team runs the readiness check before the application opens, as part of Medicaid enrollment across states.

Documents You Need Before You Start

SCDHHS checks specific conditions on each document, and a file that looks complete can still stall on a mismatch no one caught at intake.

Taxonomy is the expensive one. A code that doesn’t match your NPPES record triggers an automated hold, and the application doesn’t fail loudly. It sits. Your staff assumes SCDHHS is running behind, and six weeks disappear before someone checks the status.

How Long SC Medicaid Enrollment Takes and What You Can Bill

SCDHHS processes enrollment applications within 30 business days from the date of receipt. The count runs in business days, which is why any source quoting you 60 to 90 days is describing something other than the state’s published standard.

Per the SCDHHS enrollment screening FAQs, four conditions extend that window:

• SCDHHS needs additional information from you
• Your provider type requires a site visit
• Your provider type requires a contractual agreement
• You submitted the application with sanction information attached

The 90-Day Retroactive Effective Date

On approval, your SC Medicaid provider enrollment effective date begins up to 90 days before SCDHHS received the application, provided the provider held licensure and met all requirements throughout that period. Most practices never learn this rule exists, and it decides whether care already delivered turns into revenue.

Three limits sit on top of it. SCDHHS won’t pay claims dated before your effective date. It won’t pay claims dated before your licensure or certification date. And when your provider type requires a contractual agreement, your enrollment date becomes the contract effective date instead of the backdated one.

The math runs against you every week you wait. Delay submission by a month and a month of care falls off the back of the look-back window. Those services don’t get paid late. They stop being billable at all. Confirming that the provider held an active license across the full look-back period is part of what our eligibility verification services team checks before we file.

Risk Categories, Site Visits, and Background Checks

CMS assigns every provider type a screening level, and SCDHHS layers state-specific designations on top. Your level decides what you submit and how long approval takes. Per 42 CFR 455.450 screening levels, the three levels work like this.

The July 1, 2026 SCDHHS Provider Administrative and Billing Manual adds an escalation rule. A provider that fits more than one categorical risk level moves to the highest level that applies.

What Triggers a Fingerprint Check

Fingerprint-based criminal background checks apply to high-risk providers only, effective August 15, 2022. Plenty of published guidance gets this wrong and tells moderate-risk providers to prepare for fingerprinting, which sends practices chasing a requirement that was never theirs.

Per the SCDHHS fingerprint check FAQ, the qualifying high-risk types are newly enrolling and revalidating home health agencies and DMEPOS suppliers, along with any person or entity holding 5 percent or greater direct or indirect ownership interest in one.

One provision in that FAQ saves weeks and shows up nowhere in commercial guidance. If you’re already enrolled as high-risk with Medicare and compliant with Medicare’s fingerprint requirements, SCDHHS treats you as compliant with its own. Check your Medicare status before you book an appointment.

Behavioral Health Providers: SLED and Site Visits

Behavioral health carries its own screening track, and it’s the segment most often given the wrong answer. Per the SCDHHS LIP and RBHS bulletin, currently enrolled LIP, MTCM, and RBHS providers face level 1 and level 2 fingerprint-based background checks with both SLED and the FBI. Newly enrolling LIP and RBHS providers face the same checks.

Newly enrolling LIP and RBHS providers also undergo a pre-enrollment site visit. Build both into your timeline before you promise a start date to a new clinician.

The consequences sit in the billing manual. Refusing to consent to a criminal background check gives SCDHHS grounds to deny your application or terminate an active enrollment. Refusing a site visit does the same.

Risk level isn’t something you pick. SCDHHS assigns it by provider type, and it changes what you submit and how long you wait. If you’re unsure which level covers yours, our credentialing readiness audit checks the current SCDHHS listing and tells you what it means for your timeline.

Does SC Medicaid Charge an Enrollment Application Fee?

Some providers pay a fee and most don’t. Federal rule requires state Medicaid agencies to collect the applicable application fee before executing a provider agreement, and SCDHHS applies it only to provider types CMS has identified as institutional.

SCDHHS collects it through the SC.gov Enterprise Payment System. The agency doesn’t accept paper checks.

Four groups are exempt:

• Individual physicians and non-physician practitioners
• Providers who already paid the fee to Medicare
• Providers who already paid another state’s Medicaid or CHIP program for the same jurisdiction
• Providers granted a hardship waiver

When the fee does apply, it applies to initial enrollment, reactivation, revalidation, and adding a new practice location. Budget for it on each of those events rather than on the first application alone.

On the amount, we’ll tell you what we verified and what we couldn’t. Per the Federal Register CY2026 fee notice, the federal application fee for calendar year 2026 is $750. We could not locate a 2026 SCDHHS bulletin publishing a South Carolina-specific figure. Confirm the amount required at the time of submission through SCDHHS before you pay anything.

Group Practices: How Provider Affiliation Works

A group enrolls its EIN under a Type 2 NPI as the billing entity. Each rendering clinician enrolls under a Type 1 NPI. Neither enrollment does the job alone, because SCDHHS won’t pay a claim from a rendering provider who isn’t linked to the group’s active billing profile.

The Written Affiliation Request

Plenty of published guidance says the group associates its clinicians inside the portal. SCDHHS handles it the other way around. Organizations can’t affiliate individuals during online enrollment.

Per the SCDHHS enrollment screening FAQs, the procedure runs like this:

1. The individual provider submits the affiliation request.
2. Put the request in writing on business letterhead.
3. Include the group’s Medicaid Legacy ID and the individual’s NPI.
4. Fax it to (803) 870-9022 or mail it to Medicaid Provider Enrollment, PO Box 8809, Columbia, SC 29202-8809.
5. Allow about 10 days for processing.

A related rule generates the same volume of failed phone calls. SCDHHS won’t take provider file updates by phone. Address changes, name changes, and location changes all go in writing on business letterhead with an authorized signature, and those take about 10 days too.

Practices that assume the affiliation happened find out through denied claims, weeks after the new clinician started seeing patients. By then the timely filing clock has been running on every one of those encounters. Coordinating affiliations across a full roster is part of our group practice billing support.

The Five Healthy Connections MCOs and How to Contract With Them

SC Medicaid provider enrollment with the state comes first. MCO contracting comes second. The plans won’t open their review until SCDHHS confirms your enrollment, so firing off five applications on day one burns five applications.

Healthy Connections Choices is the member-side enrollment broker that helps beneficiaries pick a plan, and providers don’t panel through it. Per the SCDHHS MCO provider page, each MCO runs its own provider enrollment, reimbursement, and authorization processes, so you apply to each plan directly.

Five applications, five portals, and five sets of documentation standards, all after the 30 business days you already spent waiting on the state. If running that alongside a full schedule isn’t realistic, our payer enrollment specialists carry the whole sequence.

Two details go missing from most published guidance. Nothing forces you to contract with an MCO, and the plan won’t reimburse you for services delivered to its members if you skip it. Providers enrolled only as Ordering/Referring sit outside the requirement and don’t need MCO contracts at all.

Work all five in parallel once your Medicaid ID lands. Absolute Total Care, Healthy Blue, Humana Healthy Horizons, Molina, and First Choice each run a different portal, a different document checklist, and a different credentialing committee calendar.

SC Medicaid Revalidation Changed on June 1, 2026

Effective June 1, 2026, providers classified as high-risk under 42 CFR 455.450, plus the SC provider types the state designates as high-risk, revalidate every year. All other providers revalidate every three years. Per SCDHHS revalidation requirements, South Carolina now runs on a shorter cycle than the federal five-year minimum.

SCDHHS attributes the shift to a CMS initiative launched in April 2026 that directed states to prioritize revalidation of high-risk providers and file a two-year revalidation strategy. We attribute that to SCDHHS instead of to CMS, because we couldn’t locate the underlying CMS letter on a federal posting. The state’s CMS-approved plan covers complete revalidation of providers whose initial enrollment predates June 1, 2025.

The scale explains the pace. SCDHHS published a revalidation strategy that sorts close to 76,000 providers into rapid and routine tracks, with 5,713 flagged for rapid revalidation inside 12 months. Rapid revalidation carries documentation review, site visits, and fingerprint-based background checks.

The SCDHHS revalidation page contradicts itself, and you need to know which half to follow. An older FAQ paragraph on that page still describes the federal five-year and three-year cycles. The Key Changes block above it states the current South Carolina intervals effective June 1, 2026. Follow the Key Changes block.

Who Is in the 2026 Rapid Revalidation Cohort

SCDHHS names the cohort on its revalidation page. Check whether your provider type sits on this list before you plan anything for the next 12 months:

• Opioid treatment programs
• Durable medical equipment suppliers
• Home health agencies
• Hospice providers
• Skilled nursing facilities
• Private rehabilitative behavioral health service providers
• Individual licensed psychologists
• Licensed independent social workers in clinical practice
• Licensed professional counselors and licensed marriage and family therapists
• Licensed psych-educational specialists
• Board certified behavior analysts and board certified assistant behavior analysts
• Multi-specialty groups made up of those practitioners
• Community long-term care providers delivering home and community-based services

The 30-Day Deadline and What Happens If You Miss It

Wait for the notification letter before you start. It carries a unique revalidation number, and the application won’t open without it. Starting early accomplishes nothing.

You get 30 days from the date on that letter. Miss it and SCDHHS records a voluntary termination, which ends your enrollment without further notice. Payments stop, and you reapply from an empty application.

Three operational details save people who are already inside the window:

• The revalidation entry screen asks for the revalidation number, the Medicaid Legacy ID, and the NPI
• High-risk providers whose fingerprinting or site visit won’t finish inside 30 days can submit the fingerprinting appointment confirmation with their other documents and avoid termination
• Changing financial information during revalidation triggers a 15-day prenotification period, and reimbursement arrives by paper check for that stretch

SCDHHS mails revalidation letters to the address on file. A practice that moved and never filed a written address update doesn’t get the letter, and the first sign of trouble is a payment that stops arriving.

Revalidation letters don’t chase you. If your practice has moved, added a location, or changed its billing address in the last three years, check what SCDHHS has on file before a letter goes somewhere else. We track revalidation dates for the practices we bill for, because a termination lands straight in accounts receivable recovery.

Why SC Medicaid Started Rejecting Claims on July 1, 2026

Effective July 1, 2026, SCDHHS began rejecting fee-for-service claims when ordered or referred services arrive without the federally required ORP information, including the ordering or referring professional’s NPI. These come back as rejections, so the claim never reaches adjudication, no payment follows, and no denial code posts to work from.

The mechanic catches billing teams off guard. Your rendering provider can hold a spotless enrollment and the claim still fails, because the failure sits in the ORP field. Teams start auditing the rendering provider’s file and find nothing wrong with it. Our denial management services team sees this pattern every time a state activates an ORP edit.

Group NPIs Fail in the ORP Field

Per the SCDHHS Billing Manual July 2026, ORP providers must hold an NPI with an entity type code of 1. Organizations can’t order, refer, or prescribe. A group NPI in the ORP field won’t clear the edit, and the group’s SC Medicaid provider enrollment status makes no difference to that outcome.

The reverse failure runs alongside it. SCDHHS has stated that claim edits will block payment when a provider enrolled as Ordering/Referring submits their NPI as a billing provider. Two opposite mistakes produce the same zero payment.

Four changes close the gap:

• Capture the ordering provider’s individual NPI at intake, before anyone builds the claim
• Verify the ORP provider’s active SCDHHS enrollment before the claim goes out
• Confirm the NPI in the ORP field carries entity type code 1
• Route ORP rejections to enrollment review instead of the coding queue

That last one saves the most money. A coder can’t fix an ORP rejection, and reworking the same claim four times ages it toward timely filing while the cause sits untouched. Claims that fire during an open credentialing window follow a similar pattern, which we break down in PR-242 enrollment denials.

The Trading Partner Agreement Your Billing Company Also Has to Sign

Providers execute a Trading Partner Agreement with SCDHHS and return the signed Healthy Connections Medicaid TPA enrollment form. SCDHHS then sends the website address and the Web Tool user IDs.

The reciprocity rule is where practices get stuck. Per the SCDHHS Billing Manual July 2026, if you use a billing agent and want that agent to reach your electronic remittance advice, both parties need a TPA on file. Your TPA has to name your billing agent. Your billing agent’s TPA has to include your name and your Medicaid number.

One side on its own does nothing.

The failure looks the same every time. A practice finishes enrollment, gets approved, hires a billing company, and then can’t work out why ERAs aren’t landing. The enrollment is clean. The claims are clean. Someone skipped the TPA cross-reference on one of the two sides.

We sign these. When a South Carolina practice comes to us mid-year, the TPA cross-reference is one of the first things we pull, because it’s the most common reason a technically correct enrollment produces no electronic remittance at all.

The TPA also travels inside the enrollment application. You accept it by electronic signature alongside the participation agreement, the EFT agreement, and the W-9, which means plenty of providers sign one without registering that they did.

If your ERAs aren’t landing and your enrollment looks clean, check the TPA on both sides before you check anything else. That’s the sort of thing our full revenue cycle management team catches in the first week of an engagement.

ID.me Is Coming to the SC Medicaid Web Tool

Per the SCDHHS ID.me login FAQ, providers will use ID.me to log in to the Medicaid Web Tool at scdhhs.gov/providers starting in 2026. A free ID.me account will be required. SCDHHS hasn’t announced the launch date.

Once it launches, users get 90 days before the ID.me account becomes mandatory for Web Tool access.

One consequence hasn’t reached any published guidance. ID.me verifies each account per individual and ties it to one person, the way a driver’s license does. You can’t hold two. No shared practice login exists, and no shared billing-company login exists either.

Work out what that means for your staffing before the launch date lands. Three people checking eligibility means three verified accounts. A billing company covering several South Carolina clients needs a verified identity for every team member who touches the Web Tool, which is worth planning before you scale a remote team or bring on billing virtual assistants.

The precedent is on record. SCDHHS moved the member-side portal at apply.scdhhs.gov to ID.me in January 2024, and the old logins stopped working on the transition date. Identity verification takes time, and the day your access breaks is a bad day to start.

Enrollment Problems That Show Up as Denials

When the same NPI rejects across several payers at once, the cause almost never sits in data entry. It sits in an enrollment record, and the billing team is the first group to see it.

The last row needs a word of explanation, because it’s a billing rule rather than an enrollment gap. Medicaid operates as payer of last resort under Section 1902(a)(25) of the Social Security Act. A commercial primary has to adjudicate before Medicaid pays, and filing Medicaid as primary when commercial coverage exists is a third party liability violation. We cover the sequencing in Medicaid coordination of benefits.

Route enrollment-caused rejections to enrollment review. Practices that send them to the coding queue rework the same claim over and over and never touch the cause. Our breakdown of clearinghouse rejection codes maps which rejections signal an enrollment gap and which signal a formatting error.

Handling SC Medicaid Enrollment In-House or Outsourcing It

Start with the honest case for doing it yourself. One provider enrolling with SCDHHS and one or two MCOs is a manageable internal job. If your practice manager has done it before, has the documents ready, and has room for the follow-up calls, paying someone else adds cost without adding much.

It stops being manageable at four points:

• Multiple providers, where each affiliation takes its own written request
• Multiple states, where every program runs different rules and a different portal
• A high-risk or behavioral health provider type, where fingerprinting and site visits enter the timeline
• Any revalidation cohort year, where a missed 30-day letter ends the enrollment

Enrollment errors don’t surface at enrollment. They surface eight weeks later in your rejections. A credentialing vendor hands you the approval letter and closes the file. A billing team finds out what that approval is worth when the first 200 claims come back.

One O Seven RCM handles SC Medicaid provider enrollment, the five MCO applications, and the billing that follows, under one team. If you want to know what your provider type and timeline look like before you commit to anything, that’s where we’d start. See outsourced provider enrollment.

SC Medicaid Provider Enrollment: Common Questions

How do I enroll as a provider in SC Medicaid?

Go to providerservices.scdhhs.gov and select Begin a New Enrollment. Choose your enrollment type, enter the minimum information to receive a Reference ID, then complete the application with your NPI, taxonomy code, ownership disclosures, and practice locations. Fax supporting documents to (803) 870-9022 with the Reference ID on every page. SC Medicaid provider enrollment closes when SCDHHS notifies you in writing.

How long does SC Medicaid provider enrollment take?

SCDHHS processes applications within 30 business days from the date of receipt. Four conditions extend that: the agency needs more information, your provider type requires a site visit, your provider type requires a contractual agreement, or you submitted the application with sanction information attached. High-risk providers awaiting fingerprinting or a site visit should plan for longer.

How can I check the status of my SC Medicaid provider application?

Call the Provider Service Center at (888) 289-0709 and select option 4. Have your Reference ID and NPI ready before you dial, because the representative will ask for both. For an application still in process, the Reference ID is the only way to locate it, and the file gets purged if you don’t submit within 30 days of receiving that number.

What is the SC Medicaid provider enrollment phone number?

The SCDHHS Provider Service Center is (888) 289-0709, option 4. Hours are Monday through Thursday, 7:30 a.m. to 5 p.m., and Friday, 8:30 a.m. to 5 p.m. Use issue code REVAL when you call about revalidation. Supporting enrollment documents go by fax to (803) 870-9022.

Do providers have to enroll in Medicaid?

Yes. Federal law at 42 CFR 455.410(b) requires all ordering or referring physicians and other professionals who serve Medicaid members to enroll as participating providers with the state Medicaid agency. In South Carolina, that covers anyone who orders, refers, or prescribes for a Healthy Connections Medicaid member, whether or not they ever submit a claim.

How long does Medicaid provider enrollment last?

The answer changed for South Carolina on June 1, 2026. High-risk providers now revalidate every year, and all other providers revalidate every three years. That runs shorter than the federal five-year minimum many national sources still quote. Missing the 30-day revalidation deadline ends the enrollment, and the provider reapplies from the beginning.

What is my South Carolina Medicaid provider number?

SCDHHS issues your Medicaid provider number, also called the Medicaid Legacy ID, once it approves your enrollment. The approval notice carries it. You’ll need it for group affiliation requests, for revalidation, and any time the Provider Service Center asks you to identify a file.

Do I need to enroll separately with each Healthy Connections MCO?

Yes, if you want the plan to pay you. SCDHHS confirms your state enrollment first, then you contract with each MCO directly. South Carolina has five: Absolute Total Care, Healthy Blue, Humana Healthy Horizons, Molina, and First Choice by Select Health. Providers enrolled only as Ordering/Referring don’t need MCO contracts.

Can I bill for services provided before my enrollment was approved?

In many cases, yes. Your enrollment effective date can backdate up to 90 days before SCDHHS received the application, provided the provider held licensure and met all requirements across that period. Two limits apply: SCDHHS won’t pay claims dated before the effective date or before the licensure date. A required contractual agreement replaces the backdated date with the contract date.

What happens if I miss my SC Medicaid revalidation deadline?

SCDHHS treats you as voluntarily terminated. Payments stop, and you reapply from an empty application rather than updating the old one. Providers get 30 days from the date on the notification letter. High-risk providers who can’t finish fingerprinting or a site visit inside the window can submit their fingerprinting appointment confirmation and avoid termination.

Do residents and interns need to enroll with SC Medicaid?

Residents and interns can’t complete a full enrollment under current SC policy. They enroll through the Ordering/Referring provider type instead, which produces an ORP-only Medicaid ID. That ID works for ordering, referring, and prescribing. It can’t be used to render services or submit claims, so teaching practices need it mapped before claims go out.

Is there an application fee for SC Medicaid provider enrollment?

Only for provider types CMS identifies as institutional. Individual physicians and non-physician practitioners are exempt, along with providers who already paid Medicare or another state’s Medicaid or CHIP program for the same jurisdiction. The federal CY2026 fee is $750. Confirm the current amount with SCDHHS at submission. For help across the whole process, see SC Medicaid enrollment help.