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CareSourceMedicaid · Billing Codes · Specialty Services · OH · Physical Therapy, Occupational Therapy, Speech TherapyHigh impact

[Ohio] Home Health Provider Type 60 Medicare Certified Home Health Agencies (MCHHA)

Effective date
Aug 1, 2025
Identified
May 9, 2026

Summary

CareSource will enforce a provider type requirement for Ohio Medicaid home health claims: only Provider Type 60 (Medicare Certified Home Health Agencies) may bill G-codes for home health services. Claims submitted with G-codes from any other provider type will be denied. Providers with incorrect provider type classifications must coordinate with the Ohio Department of Medicaid to update their records.

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What to do

Action · 5 steps
01Before August 1, 2025: Billing team must verify that your practice's provider type is correctly classified in the Provider Network Management (PNM) system as Provider Type 60 if submitting G-code claims for Ohio Medicaid home health services.
02Contact the Ohio Department of Medicaid immediately if your provider type is incorrect—do not submit claims under an incorrect type.
03Update billing software validation rules to reject or flag any G-code claims billed under provider types other than 60 for Ohio Medicaid.
04Notify all providers and staff that claims with G-codes from non-Provider Type 60 entities will be denied by CareSource.
05For questions or to verify provider type status, contact CareSource Provider Services at 1-800-488-0134 (Monday-Friday, 8 a.m.–6 p.m. ET).
If missed: Failure to comply will result in systematic claim denials.

Codes mentioned

G0463G0464G0465G0466G0467G0468G0469G0470

Original notice

[Ohio] Home Health Provider Type 60 Medicare Certified Home Health Agencies (MCHHA)
caresource.com · Always check the source before changing claims.
View original ↗

Related policy hubs

CareSource policiesOH policy changesPhysical TherapyOccupational TherapySpeech TherapyCode G0463Code G0464Code G0465Code G0466Code G0467Code G0468Code G0469Code G0470

Summaries are AI-assisted. Always confirm against the original payer notice.

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