MedicaidCoverageMedium impact
5160-28-03 - FQHC and RHC services: covered services, limitations, and copayments. (New/Final File)
Ohio Medicaid·OH · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has finalized new Rule 5160-28-03 establishing covered services, limitations, and copayments for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). This rule replaces previous FQHC-only coverage policies and now includes RHC services under the same regulatory framework.
Action Required
Review current billing procedures for FQHC and RHC Medicaid claims to ensure compliance with new combined coverage and limitation policies. Contact Ohio Department of Medicaid at 614-752-3877 for specific service coverage questions. Verify that billing staff understand any new copayment requirements for these facility types.