MedicaidCoverageMedium impact
5160-4-02.3 - Exception for certain services provided by residents. (New/Final File)
Ohio Medicaid·OH·Medical Policy
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has finalized Rule 5160-4-02.3 creating an exception for certain services provided by medical residents. This rule became effective September 1, 2021, but appears to be newly posted in the system, suggesting potential recent clarifications or enforcement changes.
Action Required
Immediately: Billing teams in Ohio should review Rule 5160-4-02.3 to understand the specific exceptions for resident-provided services under Ohio Medicaid. Contact the Ohio Department of Medicaid at 614-752-3877 for clarification on which services qualify for exceptions and how to properly bill these encounters. Verify current billing practices align with the established exceptions.