MedicaidAdministrativeMedium impact
[Ohio] Policy Updates June 2025
CareSource·OH · Pain Management, Genetics·Medical Policy
Effective date
Aug 1, 2025
We identified it
May 9, 2026
Summary
CareSource Ohio Medicaid released four policy updates effective August 1, 2025: revisions to Genetic Testing and Counseling (MM-0003), Three-Day Payment Window (AD-1001), Peripheral Nerve Stimulators for Pain Treatment (MM-1333), and Medical Record Documentation Standards for Practitioners (AD-0753). The billing team must review each revised policy on CareSource.com to identify specific changes and implement necessary workflow updates before the effective date.
Action Required
By July 25, 2025: Billing team must access each of the four revised policies on CareSource.com (Providers > Tools & Resources > Provider Policies > Ohio Medicaid) and review the full policy text to identify specific changes: (1) Genetic Testing and Counseling (MM-0003), (2) Three-Day Payment Window (AD-1001), (3) Peripheral Nerve Stimulators for Treatment of Pain (MM-1333), and (4) Medical Record Documentation Standards for Practitioners (AD-0753). Compare each revised policy against the archived previous version to identify what changed. Update billing software, encounter forms, prior authorization processes, and staff training documentation accordingly. Ensure all providers are informed of changes to documentation standards. Failure to implement changes by August 1, 2025 may result in claim denials or compliance issues with CareSource Ohio Medicaid.