Please refer to the table found on this page and the draft rules for additional information about documentation necessary for addition of each of the new specialties.
|
Specialty |
Delivery System(s) |
Description |
Provider Types for Specialty Addition |
Required Documentation |
|---|---|---|---|---|
|
ORC – CANS Assessor |
Ohio Medicaid Managed Care Organizations:
OhioRISE (Aetna Better Health of Ohio) Fee-for-Service |
Ohio Children’s Initiative CANS assessors certified through the Praed Foundation who have completed live Ohio Children’s Initiative CANS training For more information, visit the OhioRISE CANS Resources page |
Rendering Provider Type:**
Billing Provider Type:
|
Praed Foundation certification in the Ohio Children’s Initiative CANS |
|
ORM – MRSS *Please note: due to OhioMHAS certification activities occurring later this spring and summer, providers may need to add the MRSS specialty in the PNM portal on or after July 1 (see ‘What’s next?’ in the email message). |
Ohio Medicaid Managed Care Organizations OhioRISE (Aetna Better Health of Ohio) Fee-for-Service |
MRSS agencies with appropriate certification from the Ohio Department of Mental Health and Addiction Services (OhioMHAS) OAC 5160-27-13 |
Billing Provider Type:
|
MRSS Certification from OhioMHAS
|
|
847 – IHBT (includes IHBT, MST, and FFT) |
Prior to July 1: Ohio Medicaid Managed Care Organizations Fee-for-Service Medicaid Beginning July 1: OhioRISE (Aetna Better Health of Ohio) |
Entities with current IHBT certification from OhioMHAS OAC 5160-27-05 OAC 5160-59-03.3 |
Billing Provider Type:
|
IHBT Certification from OhioMHAS OAC 5122-29-28 |
|
ORE – OhioRISE Care Management Entity (CME) *Please note, a separate communication about adding the CME specialty will be sent directly to selected CMEs. |
OhioRISE (Aetna Better Health of Ohio) |
OhioRISE CMEs contracted with the OhioRISE plan to provide Care Coordination services OAC 5160-59-03.2 |
Billing Provider Type:
|
Documentation of selection/contracting with the OhioRISE plan (Aetna Better Health of Ohio) to provide CME services |
|
OHR – OhioRISE BH Respite and OhioRISE Waiver Transitional Services and Supports (TSS) |
OhioRISE (Aetna Better Health of Ohio) |
Providers contracted with the OhioRISE plan to provide Behavioral Health Respite services OAC 5160-59-03.4 |
Billing Provider Type:
|
Attestation statement that the provider is contracting with the OhioRISE plan (Aetna Better Health of Ohio) to provide BH respite and/or TSS services |
|
Providers contracted with the OhioRISE plan to provide OhioRISE Waiver TSS OAC 5160-59-05.2 |
Billing Provider Type:
Rendering Provider Type (if not employed by the above entities):
|
|||
|
ORR – OhioRISE Waiver Out of Home Respite |
OhioRISE (Aetna Better Health of Ohio) |
Entities contracted with the OhioRISE plan to provide OhioRISE Waiver Out of Home Respite OAC 5160-59-05.1 |
Billing Provider Type:
|
Attestation statement that the provider is contracted with the OhioRISE plan (Aetna Better Health of Ohio) to provide Out-of-Home Respite services |
|
*Required documentation refers to documentation submitted specific to the specialty being requested. Providers must also provide documentation specific to the provider type under which they enroll in Ohio Medicaid **Must be affiliated with a Community Mental Health Agency, SUD Agency, or Care Management Entity (CME) or be an independent behavioral health practitioner, in accordance with OAC 5160-8-05 |
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