MedicaidAdministrativeMedium impact
5160-59-01 - OhioRISE: definitions. (New/Final File)
Ohio Medicaid·OH · Pediatrics, Psychiatry, Family Medicine·Managed Care
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Ohio has established new definitions for the OhioRISE program, a specialized managed care program for children and youth with complex behavioral health and multi-system needs. This creates a framework for Medicaid services under this specialized program.
Action Required
Ohio providers serving children/youth with complex behavioral health needs should review OhioRISE program definitions and requirements. Billing teams should verify if any current pediatric behavioral health patients qualify for OhioRISE services and ensure proper enrollment and billing procedures are followed for this specialized Medicaid managed care program.