MedicaidCoverageMedium impact
5160-3-16.3 - Nursing facilities (NFs): private rooms. (New/Final File)
Ohio Medicaid·OH · Geriatrics, Internal Medicine·Medical Policy
Effective date
Sep 9, 2024
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has implemented new regulations (Rule 5160-3-16.3) governing private rooms in nursing facilities, effective September 9, 2024. This policy replaces previous versions and establishes updated requirements for private room accommodations in nursing facilities under Ohio Medicaid coverage.
Action Required
By September 9, 2024: Billing teams working with nursing facilities should review updated Ohio Medicaid requirements for private room billing and documentation. Verify that nursing facility claims comply with new Rule 5160-3-16.3 standards. Contact Ohio Department of Medicaid (Tommi Potter, 614-752-3877) for specific billing guidance if handling nursing facility private room claims.