Ohio Code 5164.761 – Beta testing of updates to billing codes or payment rates
Before the department of medicaid or department of mental health and addiction services updates medicaid billing codes or medicaid payment rates for community behavioral health services as part of the behavioral health redesign, the departments shall conduct a beta test of the updates. Any medicaid provider of community behavioral health services may volunteer to participate in the beta test. An update may not begin to be implemented outside of the beta test until at least half of the medicaid providers participating in the beta test are able to submit under the beta test a clean claim for community behavioral health services that is properly adjudicated not later than thirty days after the date the clean claim is submitted.
Terms Used In Ohio Code 5164.761
- Behavioral health redesign: means revisions to the medicaid program's coverage of community behavioral health services beginning July 1, 2017, including revisions that update medicaid billing codes and payment rates for community behavioral health services. See Ohio Code 5164.01
- Community behavioral health services: means both of the following:
(1) Alcohol and drug addiction services provided by a community addiction services provider, as defined in section 5119. See Ohio Code 5164.01
- medicaid provider: includes a person or government entity applying for a provider agreement, a former medicaid provider, or both. See Ohio Code 5164.01