CareSourceMedium ImpactPrior Auth

[Ohio] Prior Authorization Requirement Update

Published May 9, 2026

AI Summary

CareSource Ohio Medicaid has implemented new prior authorization requirements for skin substitutive therapy procedures. This affects billing for wound care and skin graft procedures that may be performed in various medical specialties.

Action Required

Immediately: Billing team must review the full policy document at the provided URL to identify specific CPT/HCPCS codes requiring prior authorization for skin substitutive therapy. Update billing system to flag these procedures for prior auth verification before scheduling. Train clinical staff to obtain prior authorization before performing covered procedures to prevent claim denials.

Plan Types

Medicaid

States

OH

Specialties

dermatology, wound-care, plastic-surgery, general-surgery, ortho, vascular-surgery