MedicaidAdministrativeMedium impact
5160-4-04 - Advanced practice registered nurse (APRN) services. (Amend/Final File)
Ohio Medicaid·OH · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has updated Rule 5160-4-04 regarding Advanced Practice Registered Nurse (APRN) services, with the most recent amendment effective January 1, 2022. This policy change affects how APRN services are covered and billed under Ohio Medicaid programs.
Action Required
Billing teams in Ohio should review current APRN billing practices for Medicaid patients to ensure compliance with Rule 5160-4-04. Verify that APRN credentials and service billing align with Ohio Medicaid requirements. Contact Ohio Department of Medicaid at 614-752-3877 for specific billing guidance if needed.