[Ohio] Telehealth: Updates to the OAC Rule Effective Date January 1, 2026

By March 1, 2026: Billing team must implement the following changes: (1) Update billing system to REQUIRE rendering provider NPI on all Ohio Medicaid telehealth claims submitted on or after January 1, 2026; (2) Configure system to accept and properly bill new telehealth codes 98000-98016 with Place of Service (POS) 02 or POS 10 for Managed Care Entities (MCEs); (3) Remove GT modifier requirement and U modifier requirement from telehealth billing rules when code description includes telehealth/electronic service component; (4) Update provider training materials to reflect newly eligible providers (doulas, international board-certified lactation consultants) and newly covered services (doula services per rule 5160-8-43, nurse home visiting per rule 5160-21-05, PrEP counseling, pregnancy reports on ODM 10257); (5) Verify claims processing does NOT apply GT or U modifiers to codes with telehealth indicators. Providers and billing staff must also verify rendering provider NPI is captured on all encounter documentation. Failure to include NPI will result in claim denials. Contact CareSource Provider Services at 1-800-488-0134 with questions.