Personal Needs Allowance Increase

The South Carolina Department of Health and Human Services (SCDHHS) is increasing the personal needs allowance (PNA) amounts for South Carolina Healthy Connections Medicaid members residing in skilled nursing and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).

Effective Oct. 1, 2025, the PNA deduction amount will increase from $30 to $60 for individuals residing in skilled nursing facilities or ICF/IIDs. This increase does not impact individuals residing in an ICF/IID who are participating in a work therapy program. SCDHHS is processing the cost of care re-budgeted amounts for impacted members and is advising providers to complete the following steps for existing residents:

For members residing in skilled nursing facilities:

• Nursing facilities will receive Form MSC002 - PNA.
• On Form MSC002, indicate current level of care.
• Submit to BlueCross BlueShield.
• For facilities that bill in Phoenix, cost of care will be updated in Phoenix.
• Nursing facility providers with questions about this bulletin should contact the Nursing Home Provider Liaison Center at (877) 797-5409 or [email protected].

For members residing in ICF/IIDs:

• ICF/IIDs will receive Form MSC002 - PNA.
• On Form MSC002, indicate current level of care.
• Submit to regional claims and collections staff at Office of Intellectual and Developmental Disabilities.
• ICF/IID providers with questions about this bulletin should contact the Provider Service Center (PSC). PSC representatives can be reached at (888) 289-0709 from 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. Providers can also submit an online inquiry at https://www.scdhhs.gov/providers/contact-provider-representative.

For admissions to skilled nursing facilities or ICF/IID after Oct. 1, 2025, the PNA increase will be reflected in the Form 181 process.

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