MedicaidPrior AuthHigh impact
[Ohio] Medicaid: New PA documentation for rehabilitation, SNF, DME, HH/PDN — avoid delays
Anthem BCBS·OH · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy·Government Programs
We identified it
May 3, 2026
Summary
Ohio Medicaid now requires new prior authorization documentation for rehabilitation services, skilled nursing facility care, durable medical equipment, and home health/private duty nursing services. Billing teams must ensure proper PA documentation is submitted to avoid claim processing delays.
Action Required
Immediately: Billing team must update PA documentation procedures for Ohio Medicaid rehabilitation, SNF, DME, and home health/private duty nursing claims. Verify all required documentation is complete before claim submission. Review current PA processes to ensure compliance with new requirements. Failure to provide proper documentation will result in claim delays.