Section 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.Ohio Admin. Code 5160-43-08
Effective: 10/15/2021
Five Year Review (FYR) Dates: 7/23/2021 and 10/15/2026
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02, 5164.03
Prior Effective Dates: 08/01/2016, 07/01/2017