Prosthetics - MEDICAID - SOUTH CAROLINA

This South Carolina Medicaid policy covers prosthetic devices to replace missing body parts—including upper and lower limb prostheses (body‑powered, myoelectric, and hybrid systems), osseointegrated transfemoral devices, and maxillofacial/external prostheses—for patients with partial or complete amputations, stump soft‑tissue/volume issues, or related reconstructive needs. Coverage includes hybrid systems for high‑level (at/above‑elbow) amputations and myoelectric devices when viable EMG signals are present, but is constrained by device‑specific FDA approvals (osseointegration and OPRA limited to transfemoral/skeletally mature indications), excludes certain levels/uses (e.g., some wrist‑level exclusions), may require wearable components (e.g., shoe‑mounted IMU), and remains subject to member plan coverage and clinical review.

"Hybrid is a combination of body powered and myoelectric components and may be used for high-level amputations (at or above the elbow). Hybrid systems allow control of 2 joints at once."