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5160-1-14 - Healthchek: early and periodic screening, diagnostic, and treatment (EPSDT) covered services. (Amend/Final File)

Ohio Medicaid·OH · Pediatrics, Family Medicine, Internal Medicine·Medical Policy
Effective date
Nov 10, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Ohio Department of Medicaid has amended rule 5160-1-14 covering Healthchek (EPSDT) services for children and adolescents under 21. This policy change affects covered services for early and periodic screening, diagnostic, and treatment services under Ohio Medicaid.

Action Required

Action needed
By November 10, 2025: Billing teams serving pediatric patients in Ohio must review and update their understanding of Healthchek (EPSDT) covered services under Ohio Medicaid. Contact Ohio Department of Medicaid at 614-752-3877 for specific rule changes and ensure billing practices align with the amended policy requirements for patients under age 21.