MedicaidReimbursementLow impact
5160-28-06.2 - Cost-based clinics: determination of a PVPA for an OHF service on the basis of a medicaid cost report. (Rescind/Final File)
Ohio Medicaid·OH·Reimbursement
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Ohio Medicaid Rule 5160-28-06.2 regarding cost-based clinic reimbursement determination for OHF services has been rescinded as of July 1, 2022. This rule previously governed how Prospective Volume Payment Adjustments (PVPA) were calculated based on Medicaid cost reports for cost-based clinics providing Other Health Facility services.
Action Required
No immediate action required for most practices. Cost-based clinics in Ohio that previously used this rule for PVPA calculations should verify current reimbursement methodology with Ohio Medicaid and ensure they are following updated guidelines for OHF service billing.