Ohio
highOH Schedules AND Rates
Run Date and Time
Oct 15, 2026
15m 13s
Run Metrics
Fee Schedule Impacts
Run summary
This run for Ohio Department of Medicaid Fee Schedule and Rates / OH_SCHEDULES_AND_RATES identified 0 changed documents and 5 newly discovered documents. 4 item(s) are high priority. 2 newly discovered item(s) appear current or upcoming. 53 fetch error(s) occurred.
High Impact (4)
Final_Hospice_Rates_FY_2027_-_Oct_1_2026_-_Sept_30_2027_Compliant.pdf
The document provides updated Medicaid reimbursement rates for various services in Ohio counties, including routine home care and inpatient care, with specific rates for each service and county.
Highlights
- •Updated rates for Ohio counties.
- •Includes routine home care and inpatient care rates.
- •Specific rates for services like T2042, T2043, T2044, T2045.
- •Rates vary by county and service type.
Reason
The document contains specific reimbursement rate changes effective immediately, impacting billing and payments.
Watch items
CPT_and_HCPCS_level_II_Procedure_code_changes-_2026-10-01-Final.xlsx
The document outlines changes to CPT/HCPCS codes effective October 1, 2026, including updates to surgery, medicine, radiology, and evaluation and management services. It also lists genomic analysis codes with effective dates of July 1, 2026, indicating changes in payment amounts and coverage status.
Highlights
- •CPT/HCPCS changes effective October 1, 2026.
- •Genomic analysis codes effective July 1, 2026.
- •Status codes indicate changes in payment and coverage.
- •Includes surgery, medicine, radiology, and E&M services.
Reason
The document contains specific reimbursement-impacting changes with effective dates in the near future.
Watch items
Final_Hospice_Rates_FY_2027_-_Oct_1_2026_-_Sept_30_2027_Non-Compliant.pdf
The document provides updated Medicaid reimbursement rates for various Ohio counties, detailing rates for services such as routine home care and inpatient care.
Highlights
- •New rates for Ohio counties including Adams, Allen, and Ashland.
- •Rates specified for services like routine home care and inpatient care.
- •Includes specific CPT codes such as T2042 and T2043.
- •Wage index and reimbursement amounts are detailed.
Reason
The document contains specific reimbursement rate changes effective immediately, impacting billing and payments.
Watch items
ProviderAdminDrugTable-_Final.xlsx
The document outlines updates to the Medicaid fee schedule for vaccines and injectable pharmaceuticals, effective October 1, 2026. It includes changes to coverage and payment rates for specific procedure codes.
Highlights
- •Effective date: October 1, 2026
- •Updates to vaccines and injectable pharmaceuticals
- •Changes in Medicaid maximum payment rates
- •Specific CPT/HCPCS codes affected
Reason
The document includes reimbursement-impacting changes effective soon, requiring urgent review.
Watch items
Medium Impact (1)
20261002_Prior_Authorization_List_Effective_10-1-26.xlsx
The document outlines updates to Medicaid coverage for specific inpatient procedures, including new effective dates for certain procedures requiring prior authorization.
Highlights
- •New coverage effective date for brain extraction procedures: 2021-10-01.
- •Insertion of infusion device into brain effective: 2025-10-01.
- •Dilation of left femoral artery effective: 2024-10-01.
- •Destruction of brain using laser therapy effective: 2022-10-01.
- •Destruction of brain using radiofrequency ablation effective: 2024-10-01.
Reason
The document includes new effective dates for procedures, but they are not imminent, reducing urgency.
Watch items
Low Impact (0)
No documents in this severity group.