Waiver Consulting Group — Start any program. In any state.

South Carolina - Home Health Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The South Carolina Department of Public Health (DPH) licenses Home Health Agencies under Regulation 60-77 to deliver intermittent skilled nursing, physical therapy, and medical social services to patients in their residences. Agencies must secure this state license, explicitly designating the specific counties they will serve and proving physical site control, before applying for Medicaid reimbursement through the South Carolina Department of Health and Human Services (SCDHHS).

Approval requires passing a DPH site inspection and paying county-specific licensing fees, followed by submitting an enrollment application through the SCDHHS Provider Enrollment Web portal. Agencies must also individually contract with South Carolina's managed care organizations, such as Healthy Blue and Absolute Total Care, to be reimbursed for services provided to the majority of Medicaid beneficiaries enrolled in managed care.

1. Service Definition and Scope

Home Health Services in South Carolina encompass part-time or intermittent skilled nursing, home health aide assistance, and therapeutic services provided to a patient at their residence. Under Regulation 60-77, these services must be directed by an Authorized Healthcare Provider's plan of care and delivered for less than eight hours per day.

Agencies may operate branch offices under a parent agency's license, provided they are located sufficiently close to share administration and supervision.

2. Regulatory and Oversight Agencies

The South Carolina Department of Public Health (DPH) handles the licensure and regulatory enforcement for Home Health Agencies. The South Carolina Department of Health and Human Services (SCDHHS) manages Medicaid provider enrollment and sets reimbursement policies.

Because South Carolina utilizes a managed care model for most Medicaid beneficiaries, providers must also interact directly with individual Managed Care Organizations (MCOs) for network inclusion.

3. Gatekeeping Prerequisites: Who Can Even Apply

South Carolina requires Home Health Agencies to obtain a state license from DPH before enrolling in Medicaid. Applicants must establish a physical location and secure the legal right to occupy the space prior to submitting the initial DPH application.

Agencies must also explicitly define their geographic service area at the time of application, as DPH licenses are issued for specific counties.

4. Licensure and Certification Requirements

DPH issues Home Health Agency licenses under Regulation 60-77. Licenses are location-specific, non-transferable, and require payment of base and county-specific fees.

Any changes to the agency's name, location, or service area require an amended license application and additional fees.

5. Medicaid Provider Enrollment

After obtaining DPH licensure, agencies must enroll as Medicaid providers through the SCDHHS Provider Enrollment Web portal. The state categorizes home health agencies by risk level, which dictates the intensity of the pre-enrollment screening.

Enrollment applications are processed electronically, but supporting documentation must be faxed to the state with a specific reference identifier.

6. Staffing, Training and Background Checks

Regulation 60-77 mandates that all Home Health Agency staff be properly licensed or credentialed in South Carolina. Agencies must designate qualified administrative and clinical leadership to oversee daily operations and patient care.

Staff must be trained to perform their assigned duties effectively and safely.

7. Documentation, Policies and Records

Agencies must maintain comprehensive records for all patients and adhere to strict quality improvement processes. DPH regulations require individualized assessments and physician-ordered plans of care.

Branch offices must maintain integrated documentation systems with their parent agency.

8. Billing, Rates and Claims

Home Health Agencies bill SCDHHS for fee-for-service Medicaid beneficiaries and must contract with MCOs for managed care enrollees. Providers must ensure their billing identifiers match their state registration and MCO contracts.

Failure to align credentials across systems will result in claim denials.

9. Approval Sequence and Timeline

The approval process begins with establishing a physical location and applying for DPH licensure. Once licensed, the agency applies for Medicaid enrollment and subsequently pursues MCO contracts.

The entire sequence can take several months depending on DPH survey scheduling and MCO credentialing timelines.

10. Common Denials and Survey Findings

DPH and SCDHHS can deny applications or revoke licenses for failure to meet regulatory standards or screening requirements. High-risk screening findings are a primary cause for Medicaid enrollment denial.

Operating outside of approved geographic areas or without proper staff licensure will result in immediate citations.

11. Key Contacts and Resources

Providers must interact with DPH for licensing inquiries and SCDHHS for Medicaid enrollment support. MCOs maintain their own provider relations departments for contracting.

Always refer to the official state portals for the most current forms and fee schedules.

See all South Carolina services · South Carolina Medicaid consulting · book a consultation.