Ohio Admin. Code 5160-4-01 - Specific provisions for services rendered by a physician
(A) Payment may be made for a
covered service rendered by a physician only if the following conditions are
met:
(1) The physician is currently
enrolled as an Ohio medicaid provider;
(2) The service is rendered to a
medicaid-eligible Ohio recipient in a state in which the physician is licensed
or authorized to practice; and
(3) The service is within the scope
of practice of the physician's specialty.
(1) The services contribute directly to the
diagnosis or treatment of an individual patient;
(2) Any applicable requirements set forth in
agency 5160 of the Administrative Code are satisfied; and
(3) The expenses associated with the
provision of the professional services are excluded from the cost report of the
facility.
Notes
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02
Prior Effective Dates: 04/07/1977, 10/01/1983 (Emer.), 12/29/1983, 09/01/1989, 03/26/2001, 09/01/2005, 10/25/2008, 08/02/2011, 12/02/2011 (Emer.), 03/02/2012, 10/01/2017
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