# Medical Services Rule Update Summary The South Dakota Department of Social Services has updated its hospital payment rules to modernize how Medicaid reimburses both in-state and out-of-state hospitals for inpatient and outpatient services. The changes replace outdated payment formulas based on historical cost data with current industry-standard methods, including updated diagnosis-related group (DRG) classifications and a more transparent fee schedule published on the department's website. The department also removed duplicative rules about medical coding standards (CPT, ICD-10, HCPCS) that now mirror federal requirements, and streamlined requirements for billing and prior authorization to reduce administrative burden on providers and the state.
AI-generated from the adopted rule text — verify against the official documents.
Updates hospital reimbursement methodologies including inpatient and outpatient hospital services for both instate and out-of-state hospitals to more closely align with industry standards, repeal rules that are duplicative of federal regulation or other rules, and to make style and form changes.
No specific cites listed — see the package documents.
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