Complete Story


In case you missed it - updates made to forms for Medicaid Behavioral Health Services

Source: Ohio Department of Medicaid


Updates have been made to two forms used by Medicaid behavioral health providers. The form updates, made in collaboration with MCOs and BH Providers and Stakeholders, are intended to improve clarity and ease of use and reflect the new Next Generation MCOs that began coverage on February 1, 2023.

The two updated forms are:

Ohio Medicaid Authorization Form – Community Behavioral Health

Previously known as the “Uniform PA Form” this document was revised to update the services list and add new MCOs. It was also revised for clarity and ease of use. The updated form can be found on the Managed Care section of the website.

SUD Residential Treatment Notification of Admission Form

Minor updates made to this form include:

  • Clarification that MCO responses to the form are due within “one business day” of receipt
  • Clinical Contact Name” changed to “Discharge Planner”
  • Addition of new Next Generation Medicaid MCOs and their contact information

The updated SUD Residential Treatment Notification of Admission Form is available on the ODM Forms webpage by searching for “Substance Use Disorder Residential Treatment Notification of Admission Form”

Printer-Friendly Version