Ohio
highOH Schedules AND Rates
Run Date and Time
Apr 15, 2026
13m 3s
Run Metrics
Fee Schedule Impacts
Run summary
This run for Ohio Department of Medicaid Fee Schedule and Rates / OH_SCHEDULES_AND_RATES identified 1 changed documents and 4 newly discovered documents. 4 item(s) are high priority. 3 newly discovered item(s) appear current or upcoming. 53 fetch error(s) occurred.
High Impact (4)
ProviderAdminDrugTable.xlsx
The document updates Medicaid rates for certain vaccines and pharmaceuticals, effective April 1, 2026. Notable changes include rate adjustments for Hepatitis B immunoglobulin and Rabies immunoglobulin.
Highlights
- •Effective date: 2026-04-01
- •Hep B IG IM rate increased to 140.209
- •Rabies IG IM/SC rate decreased to 275.18
- •Rabies IG HT&sol human IM/SC rate increased to 242.177
Reason
The changes involve specific rate adjustments effective soon, impacting reimbursement.
Watch items
LabServicesPayment_04012026-FINAL_version_2.pdf
The document outlines updates to clinical diagnostic and pathology procedures, effective April 1, 2026, with revised payment amounts. It includes specific codes and modifiers, indicating changes in reimbursement rates.
Highlights
- •Effective date: 04/01/2026
- •Revised payment amounts for clinical diagnostics
- •Includes specific CPT codes and modifiers
- •Changes impact reimbursement rates
Reason
The document contains reimbursement-impacting changes effective soon, requiring urgent review.
Watch items
LabServicesPayment_04012026-FINAL_version_2.xlsx
The document outlines changes to clinical diagnostic and pathology procedures effective April 1, 2026, including new and discontinued procedure codes and payment amounts. Several codes require prior authorization, and some procedures are not routinely covered.
Highlights
- •Effective date for changes: April 1, 2026
- •New and discontinued procedure codes listed
- •Prior authorization required for certain codes
- •Changes in maximum payment amounts
- •Some procedures not routinely covered
Reason
The document includes reimbursement-impacting changes with specific effective dates and payment details.
Watch items
CPT_and_HCPCS_level_II_Procedure_code_changes-_2026-04-01.xlsx
The document outlines changes to CPT/HCPCS procedure codes effective April 1, 2026, including updates to surgery, medicine, radiology, and evaluation and management services. It also lists new codes requiring prior authorization effective January 1, 2026.
Highlights
- •CPT/HCPCS changes effective April 1, 2026.
- •New codes with prior authorization effective January 1, 2026.
- •Includes surgery, medicine, radiology, and E&M services.
- •Status codes indicate changes in payment amounts and discontinued coverage.
Reason
The document includes upcoming changes to procedure codes and payment amounts, impacting reimbursement.
Watch items
Medium Impact (1)
Complete_PA_List_Effective_4-1-26.xlsx
The document outlines inpatient procedures requiring prior authorization, with some effective dates extending to 2024. It includes procedures like brain extraction and destruction using various approaches.
Highlights
- •Procedures require prior authorization.
- •Includes brain extraction and destruction procedures.
- •Effective dates range from 2021 to 2024.
- •Some procedures are newly covered starting 2024.
Reason
The document includes future effective dates but lacks immediate changes impacting reimbursement.
Watch items
Low Impact (0)
No documents in this severity group.