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Ohio Department of Medicaid (ODM) has become aware of a claims payment issue impacting fee-for-service (FFS) claims submitted on or after February 1, 2023, by community mental health agencies (provider type 84) and substance use disorder agencies (provider type 95). This claims payment issue is resulting in incorrect payment amounts for certain billing codes. ODM is working with our vendor to resolve the issue as quickly as possible. During this time, providers may continue to submit claims, or providers may elect to hold claims until the issue is resolved.
Once resolved, all impacted claims will be reprocessed with the correct payment amount. Any underpayments or overpayments made as a result of the error will be adjusted through the reprocessing cycle. Providers will not be required to resubmit claims.
Please note this issue only impacts FFS claims submitted on or after February 1, 2023.
Questions may be sent to the Integrated Helpdesk at IHD@medicaid.ohio.gov.
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