[Ohio] Telehealth: Updates to the OAC Rule

By January 1, 2026 (retroactive effective date): (1) Billing team must update billing software to require rendering provider NPI on all Ohio Medicaid telehealth claims; (2) Update claim submission rules to remove GT and U modifier requirements for telehealth services with appropriate code descriptions and POS 02/POS 10; (3) For Fee-for-Service (FFS) claims, configure system to reject POS 02 and POS 10 for all codes except 98000-98016; (4) For Managed Care Entity (MCE) claims, allow POS 02 and POS 10 for codes 98000-98016 per MCE guidelines; (5) Providers must verify they are correctly billing new covered services (doula services, nurse home visiting, PrEP counseling, pregnancy reports) if applicable; (6) Verify that doulas and lactation consultants are properly credentialed in system if your practice employs them; (7) Remove billing rules that previously required GT modifiers for telehealth services. Non-compliance will result in claim denials due to missing required NPI or use of invalid modifiers.