Ohio Medicaid (ODM)

MedicaidOH

ABA billing requirements · Source: Ohio ODM — Behavioral Health Provider Manual v1.28

High confidence

Verified 2026-03-01

Authorization Requirements

Requires prior auth Yes

Initial auth duration12 months

Renewal auth durationN/A

Submission deadlineN/A

Unit tracking cadenceTotal

Requires FBA Yes

Diagnostic eval validityN/A

Re-eval cadenceN/A

State licensure requiredBCBA state licensure required via OH Counselor, Social Worker and Marriage & Family Therapist Board

Documentation Requirements

Parent signatures required Yes

Start/stop times required Yes

Treatment plan componentsBaseline data, Target behaviors, Methods

Progress summary cadenceEvery 6 months

Policy Notes

Prior authorization is required for certain services and levels of care. SUD Partial Hospitalization requires prior authorization for adults and adolescents. Refer to OAC Chapter 5160-27 and rule 5160-8-05 for service-specific requirements.

CPT & Modifier Rules

CPT rules require a free account

View H-codes, modifiers, unit limits, and billing restrictions for Ohio Medicaid (ODM).

Official policy source:Ohio ODM — Behavioral Health Provider Manual v1.28

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Data last verified: 2026-03-01 · Confidence: High · See our methodology

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