MedicaidAdministrativeMedium impact
5160-35-07 - Services that can be provided by medicaid school program (MSP) providers to eligible children enrolled in medicaid without a plan of care. (New/Final File)
Ohio Medicaid·OH · Pediatrics, Family Medicine·Managed Care
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has established new rule 5160-35-07 defining services that Medicaid School Program (MSP) providers can deliver to eligible Medicaid-enrolled children without requiring a formal plan of care. This creates a streamlined pathway for school-based healthcare services.
Action Required
Before January 1, 2026: Billing teams working with Ohio Medicaid School Program providers should review the new rule to understand which services can be billed without plan of care documentation. Update billing workflows to ensure proper documentation requirements are met for MSP services. Contact Ohio Department of Medicaid at 614-752-3877 for specific guidance on affected service codes and billing procedures.