MedicaidPrior AuthMedium impact
5160-2-40 - Pre-certification review. (Rescind/Final File)
Ohio Medicaid·OH · Psychiatry·Medical Policy
Effective date
Jun 12, 2022
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has rescinded the general pre-certification review rule 5160-2-40 and replaced it with a new psychiatric-specific pre-certification review rule. This change narrows the scope of pre-certification requirements from general medical services to psychiatric services only.
Action Required
By June 12, 2022: Billing teams should verify that pre-certification requirements for non-psychiatric services under Ohio Medicaid have been removed from billing workflows. Update prior authorization processes to focus only on psychiatric services. Review current Ohio Medicaid claims to ensure non-psychiatric services no longer require pre-certification under this rule.