MedicaidPrior AuthHigh impact
[Ohio] Prior Authorization Requirement Update
CareSource·OH·Provider Bulletin
We identified it
Jun 13, 2026
Summary
CareSource has updated prior authorization requirements for Ohio Medicaid members, introducing new quarterly codes that require prior approval. This affects billing workflow and claim submission processes for providers serving Ohio Medicaid patients.
Action Required
Immediately: Billing team must review the CareSource Ohio Medicaid quarterly new codes document to identify specific services requiring prior authorization. Update billing system to flag these codes for prior auth verification before claim submission. Train staff on new prior authorization workflow to prevent claim denials.