MedicaidCoverageMedium impact
5160-3-17.1 - Outlier services in nursing facilities for individuals with severe maladaptive behaviors due to traumatic brain injury (NF-TBI services). (Rescind/Final File)
Ohio Medicaid·OH · Neurology, PM&R (Physical Medicine & Rehab)·Medical Policy
Effective date
Oct 3, 2014
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has rescinded Rule 5160-3-17.1, which previously covered outlier services in nursing facilities for individuals with severe maladaptive behaviors due to traumatic brain injury (NF-TBI services). This service category is no longer available under Ohio Medicaid.
Action Required
Billing team should verify that no claims are being submitted for NF-TBI outlier services under Ohio Medicaid, as this service category has been rescinded. Review any pending or denied claims related to traumatic brain injury services in nursing facility settings and explore alternative billing options or coverage sources.