MedicaidReimbursementMedium impact
5160-28-05.3 - Cost-based clinics: prospective payment system (PPS) method for determining RHC payment. (Rescind/Final File)
Ohio Medicaid·OH · Family Medicine, Internal Medicine, General Practice·Reimbursement
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has rescinded Rule 5160-28-05.3 regarding the Prospective Payment System (PPS) method for determining Rural Health Clinic (RHC) payment rates. This rule was officially rescinded effective July 1, 2022, meaning Ohio Medicaid no longer uses this specific PPS methodology for RHC reimbursement.
Action Required
Rural Health Clinics billing Ohio Medicaid should verify current reimbursement methodology being used since the PPS rule was rescinded in July 2022. Contact Ohio Medicaid at 614-752-3877 or review current billing guidelines to ensure compliance with the active payment structure for RHC services.