MedicaidCoverageLow impact
5160-3-16.3 - Nursing facilities (NFs): private rooms. (Rescind/Final File)
Ohio Medicaid·OH · Geriatrics, Internal Medicine, Family Medicine·Medical Policy
Effective date
Sep 9, 2024
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has rescinded and replaced Rule 5160-3-16.3 regarding private rooms in nursing facilities, effective September 9, 2024. This represents a complete rule replacement rather than amendment, indicating significant changes to private room policies for nursing facility residents covered by Ohio Medicaid.
Action Required
By September 9, 2024: Billing teams at practices that work with nursing facilities should review the new Ohio Medicaid Rule 5160-3-16.3 for any changes to private room coverage policies. Contact Ohio Department of Medicaid at 614-752-3877 for clarification on specific billing requirements if your practice provides services to nursing facility residents.