MedicaidReimbursementMedium impact
5160-9-05 - Pharmacy services: payment for prescribed drugs. (New/Final File)
Ohio Medicaid·OH·Pharmacy
Effective date
Feb 16, 2024
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid finalized a new rule 5160-9-05 regarding pharmacy services payment for prescribed drugs, effective February 16, 2024. This rule replaced the previous version and may include updated reimbursement rates, coverage criteria, or billing procedures for Medicaid pharmacy claims.
Action Required
By February 16, 2024: Billing team should review the full rule text at the Ohio Department of Medicaid website to identify specific changes to pharmacy billing procedures, reimbursement rates, or coverage criteria. Update billing system settings and procedures for Ohio Medicaid pharmacy claims accordingly. Contact Tommi Potter at 614-752-3877 for clarification on specific requirements.