MedicaidCoverageMedium impact
5160-3-05 - Level of care definitions. (Amend/Final File)
Ohio Medicaid·OH·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Ohio Medicaid updated their Level of Care definitions under rule 5160-3-05, with the final amendment taking effect July 1, 2025. This policy defines care level criteria that may impact authorization requirements and coverage determinations for Medicaid patients.
Action Required
Before July 1, 2025: Review updated Ohio Medicaid Level of Care definitions to understand new criteria for patient care levels. Billing and clinical teams should access the full rule body at the Ohio Register website to identify specific changes that may affect authorization requirements or coverage determinations for Medicaid patients.