MedicaidAdministrativeLow impact
5160:1-4-04 - MAGI-based medicaid: coverage for pregnant individuals. (Amend/Final File)
Ohio Medicaid·OH · OB-GYN, Family Medicine, Internal Medicine·Medical Policy
Effective date
Mar 1, 2024
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has updated Rule 5160:1-4-04 to change terminology from 'pregnant women' to 'pregnant individuals' in MAGI-based Medicaid coverage requirements. This appears to be an inclusive language update with no changes to actual coverage or billing requirements.
Action Required
No immediate action required for billing team. This is a terminology change only - continue processing Ohio Medicaid claims for pregnancy-related services using existing procedures and codes.