MedicaidAdministrativeMedium impact
[Ohio] Review the Ohio Medicaid Perinatal Risk Assessment form and Report of Pregnancy billing guidance
Anthem BCBS·OH · OB-GYN, Family Medicine, Pediatrics·Claims & Billing
We identified it
Sep 2, 2026
Summary
Ohio Medicaid has issued billing guidance for the Perinatal Risk Assessment form (PRAF) and Report of Pregnancy (ROP) form to support the Maternal and Infant Support Program (MISP). Billing teams must review ODM's MISP billing guidance to ensure claims for perinatal services and maternal/infant support are submitted correctly under Ohio Medicaid managed care plans.
Action Required
Immediately: Billing team must review the Ohio Department of Medicaid (ODM) Maternal and Infant Support Program (MISP) billing guidance on ODM's website to understand proper claim submission procedures for PRAF and ROP forms. Update internal billing workflows and training materials to reflect MISP billing requirements for Ohio Medicaid claims. Direct all questions regarding guidance to MomsAndBabies@medicaid.ohio.gov. Ensure all staff submitting perinatal and maternal support claims are trained on the correct procedures before processing claims to avoid denials or rejections.