MedicaidAdministrativeMedium impact
[Ohio] Policy Updates February 2026
CareSource·OH · OB-GYN, Orthopedics, General Practice +1 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
May 9, 2026
Summary
CareSource Ohio Medicaid released six policy revisions effective April 1, 2026, affecting reimbursement (out-of-network payments, obstetrical unbundled costs), medical coverage (basivertebral nerve ablation, sacroiliac joint procedures, neonatal discharge criteria), and administrative processes (retrospective authorization review). Billing teams must review each full policy document to identify specific code and workflow impacts.
Action Required
By March 15, 2026: Billing team must access each revised policy on CareSource.com (Providers > Tools & Resources > Provider Policies) and compare against archived versions to identify specific billing code changes, prior authorization requirements, and documentation updates. Document all changes in internal policy tracking system. Identify which policies require EMR/billing software updates, staff training, or provider communication. Assign responsibility by specialty (orthopedic staff for sacroiliac joint procedures; obstetrical staff for obstetrical care and neonatal discharge; all billing staff for out-of-network payment and authorization review changes). Before April 1, 2026: Complete all system updates and staff training. Notify clinical providers of any new documentation or authorization requirements. No claims should be submitted under old policy terms after April 1, 2026.