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Ohio MedicaidMedicaid · Coverage · Medical Policy · OH · Endocrinology, Pediatrics, Internal MedicineMedium impact

5160-10-29 - DMEPOS: insulin pumps. (Amend/Final File)

Effective date
Nov 8, 2026
Identified
Oct 30, 2026

Summary

Ohio Medicaid (DMEPOS rule 5160-10-29) amended its insulin pump coverage policy. Two separate amendments are documented: one effective 2026-06-08 (now expired as of 2026-11-08) and a current amendment effective 2026-11-08. The billing team must verify current applicability with the Ohio Department of Medicaid, as the source does not specify what clinical or billing changes were made.

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What to do

Action · 4 steps
01Verify current applicability: The most recent amendment to rule 5160-10-29 (DMEPOS insulin pumps) becomes effective 2026-11-08.
02Contact the Ohio Department of Medicaid (Tommi Potter, 614-752-3877) to obtain the full rule text specifying which insulin pump HCPCS codes, prior authorization requirements, or coverage limits have changed.
03Update billing system coverage logic and prior auth workflows accordingly once the specific changes are confirmed.
04The previous amendment effective 2026-06-08 has expired (2026-11-08), so do not apply that version.

Original notice

5160-10-29 - DMEPOS: insulin pumps. (Amend/Final File)
registerofohio.state.oh.us · Always check the source before changing claims.
View original ↗

Related policy hubs

Ohio Medicaid policiesOH policy changesEndocrinologyPediatricsInternal Medicine

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