South Carolina Code of Regulations
Chapter 126 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
Article 3 - MEDICAID
Subarticle 1 - SCOPE OF THE PROGRAM
Section 126-310 - Hospital Services

A. Inpatient hospital services provided by the Medicaid Program are for the care and treatment of illness, injuries or disabilities certified medically necessary by a physician and reviewed for appropriateness of admission, length of stay and ancillary services, by the utilization review mechanism established by the State Health and Human Services Finance Commission.

B. Outpatient hospital services sponsored by the Medicaid Program are ambulatory visits for the care and treatment of illness, injuries and disabilities certified as medically necessary by a physician. This does not include routine dental services. Therapy may be provided on an ambulatory basis as a continuing part of an inpatient stay.