Medicaid Bulletin: Non-Invasive Prenatal Screening

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Medicaid

MEDICAID BULLETIN

TO: Physician Services/Healthcare Providers

SUBJECT: Non-Invasive Prenatal Screening

Effective on or after Feb. 1, 2020, the South Carolina Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for Cell-free Fetal DNA Testing, commonly known as Non-Invasive Prenatal Screening (NIPS). PA forms should be submitted through Keystone Peer Review Organization (KePro), the agency's quality improvement organization.

SCDHHS will continue to cover NIPS testing for the detection of fetal aneuploidy in pregnant women meeting specific intermediate/high-risk criteria enumerated in the updated Physicians Services Provider Manual

Please refer any questions or concerns regarding this bulletin to the SCDHHS Provider Service Center (PSC) 1-888-289-0709.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

/s/
Joshua D. Baker
Director

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