MedicaidReimbursementMedium impact
5160-2-22 - Non-DRG prospective payment for hospital services. (Amend/Original File)
Ohio Medicaid·OH·Reimbursement
Effective date
Oct 5, 2026
We identified it
Sep 5, 2026
Summary
Ohio Medicaid has filed an amendment to Rule 5160-2-22 regarding Non-DRG prospective payment for hospital services. This is a regulatory filing currently in the original file stage with an effective date of October 5, 2026. The specific policy details are not provided in the source material, requiring review of the full rule body and supporting documents to determine billing impact.
Action Required
By September 30, 2026: Billing team must review the complete rule text, CSI Business Impact Analysis, and supporting documents available at https://www.registerofohio.state.oh.us/rules/search/details/379213 to identify specific billing code changes, reimbursement rate adjustments, or documentation requirements for Non-DRG hospital services under Ohio Medicaid. Once specific changes are identified, update billing system configurations, fee schedules, and staff training accordingly. Monitor Ohio Department of Medicaid communications from contact Tommi Potter (614-752-3877) for any clarifications. Failure to implement required changes by the October 5, 2026 effective date will result in claim denials or payment adjustments for affected hospital services.