Ohio Admin. Code 5160-43-08 - Specialized recovery services program billing procedures and payment rates for recovery management
(A) Definitions of terms used for billing and
calculating rates.
(1) "Billing unit" as used
in column 4 of paragraph (C) of this rule, means a single fixed item, amount of
time or measurement.
(2) "Unit
rate" as used in column 3 of paragraph (C) of this rule, means the amount
reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of
service delivered.
(B)
Payment rates for individualized placement and support - supported employment
and peer recovery support services may be found in rule 5160-27-03 and rule 5160-1-60 of the Administrative
Code.
(C) Recovery management
billing code table.
Column 1 |
Column 2 |
Column 3 |
Column 4 |
Billing code |
Service |
Unit rate |
Billing unit |
T1016 |
Recovery management |
$ 19.00 |
15 minutes |
(D)
Claims shall be submitted to ODM via the medicaid information technology system
(MITS), and paid in accordance with Chapter 5160-1 of the Administrative
Code.
Notes
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02, 5164.03
Prior Effective Dates: 08/01/2016, 07/01/2017
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