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[Ohio] OAC Rule 5160-1-17.9 Ordering, Referring and Prescribing Providers
Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Jun 13, 2026
Summary
Starting January 1, 2027, all Ohio Medicaid claims must include the Ordering, Referring, or Prescribing (ORP) provider's NPI number or they will be denied. This affects numerous services including DME, imaging, lab work, therapies, consultations, and institutional claims.
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What to do
by Jan 1, 2027 · 4 steps
01Billing team must update all claim submission processes to include ORP provider NPI numbers for affected services including DME, imaging, lab, therapy, consultation codes 99242-99255, transportation, and institutional claims.
02Verify all ORP providers are enrolled in Provider Network Management system.
03Ensure billing software validates NPI presence before submission.
04Claims missing required ORP NPIs will be automatically denied by CareSource.
Codes mentioned
992429924399244992459925299253992549925599211
Original notice
[Ohio] OAC Rule 5160-1-17.9 Ordering, Referring and Prescribing Providers
caresource.com · Always check the source before changing claims.
Related changes
See all CareSource changes →[Georgia] 2025 Order, Prescribe and Refer (OPR) UpdateHighEffective Feb 1, 2025 · Provider Bulletin[Georgia] 2025 Order, Prescribe and Refer (OPR) UpdateHighEffective Feb 1, 2025 · Provider Bulletin[Ohio] National Provider Identifier (NPI) for Ordering, Referring and Prescribing (ORP) ProvidersHighEffective Jul 1, 2025 · Provider BulletinBrowse every CareSource change in the policy list