SD Medicaid

South Dakota is fortunate to have fee-for-service Medicaid reimbursement for CHW/CHR services. The following pages provide an extensive overview, tools, and guides to assist organizations in enrolling in SD Medicaid as a CHW Agency, implementing workflows for CHW reimbursement, and successfully billing for CHW services.

Medicare

While CHWs are not directly recognized Medicare providers, their services may be reimbursed when furnished under eligible practitioners’ supervision through Community Health Integration (CHI) and/or Principal Illness Navigation (PIN). Only CHWs working with primary care providers (PCPs) may be able to obtain Medicare reimbursement for CHW services.