12/20/2022

Updated Medicaid Behavioral Health Provider Manual issued

Changes effective January 1, 2023

ODM has published an updated version of the Medicaid Behavioral Health Provider Manual including several changes that will become effective January 1, 2023. Version 1.25 of the BH provider manual contains the following updates:

• Revised Medicaid payment rates for the administration of the Child and Adolescent Needs Survey (CANS). (This change aligns with recent updates to OhioRISE provider guidance)
• Clarification that Mobile Response Stabilization Service (MRSS) may not be billed for time spent administering the CANS assessment. (This change aligns with recent updates to OhioRISE provider guidance)
• Discontinuation of prolonged services codes (99354 and 99355) for psychotherapy services beginning January 1, 2023, and after. This follows the new CPT/HCPCS guidance from the American Medical Association (AMA) beginning January 1, 2023.
• Discontinuation of CPT code 99343, Evaluation & Management Home Visit, presenting problems moderate to high severity, typically 45 minutes. This change also follows guidance of the AMA.
• Codes added for several provider administered pharmaceuticals on Table 2-9

Questions regarding the Medicaid Behavioral Health Provider Manual may be submitted to the ODM Behavioral Health Policy mailbox, BH-Enroll@medicaid.ohio.gov.