MedicaidCoverageMedium impact
5160-21-04 - Reproductive health services: pregnancy-related services. (Amend/Final File)
Ohio Medicaid·OH · OB-GYN, Family Medicine, Internal Medicine·Medical Policy
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has finalized amendments to Rule 5160-21-04 covering reproductive health services and pregnancy-related services, effective April 1, 2025. This policy update affects billing and coverage requirements for pregnancy-related care under Ohio Medicaid.
Action Required
By April 1, 2025: Billing team must review and update pregnancy-related service billing procedures for Ohio Medicaid patients. Contact Ohio Department of Medicaid (Tommi Potter, 614-752-3877) to obtain the full rule text and specific billing requirements. Update billing system parameters and staff training materials to reflect any new coverage or documentation requirements for reproductive health services.