03/26/2024

Are You Being Paid 2024 Rates? Check Your Medicaid Claims

As a result of OSMA advocacy efforts last year, on Jan. 1 Ohio increased the Medicaid fee schedule resulting in the majority of codes increasing by 5% with a cumulative impact of about $400 million in new funding. The implementation of the increase has been challenging and it's essential that practices review their claims payment history since Jan. 1 to ensure you are receiving the appropriate increase.

The majority of claims are processed by the Medicaid Managed Care Organizations (MCOs). The Ohio Department of Medicaid has provided an update for each plan on when they implemented the new fee schedule and if it was after Jan. 1 how they are handling claims that were initially paid on the old fee schedule.

Medicaid Fee For Service (FFS) claims payment have also had some errors. Rates for numerous codes were inputted incorrectly. These are currently being updated and claims paid incorrectly will be reprocessed. Be sure to review your FFS claims to assess if payment levels are correct and contact Medicaid directly if there are errors.

Download Fee Schedule Implementation >