Effective March 1, 2022, the Ohio Department of Medicaid (ODM) and the Ohio Department of Mental Health and Addiction Services (OhioMHAS) will implement enhancements to the Intensive Home-Based Treatment (IHBT) service in accordance with new Ohio Administrative Code (OAC) rules 5122-29-28 and 5160-27-05. Medicaid billing and claims processing changes to be implemented include:
Updates to Medicaid payment rates, including new practitioner-specific rates.
The addition of qualified mental health specialists and peer supporters as eligible rendering providers of IHBT.
New billing codes and rates specific to Multi-Systemic Therapy (MST) and Functional Family Therapy (FFT).
Updates to diagnosis code requirements.
Changes to the list of behavioral health services that are allowed to be rendered to youth receiving IHBT, MST, or FFT.
IHBT services (including MST and FFT) will continue to be prior authorized and paid by the current Medicaid-managed care plans and ODM for fee-for-service members. Previous authorizations for IHBT will remain in effect.
ODM and the managed care plans will be ready to begin accepting and processing claims with these changes on March 1, 2022. After the OhioRISE program is implemented July 1, 2022, IHBT services will be available only through the OhioRISE program.
ODM updated the Behavioral Health Provider Manual to incorporate these changes.
OhioMHAS Rule 5122-29-30, which also goes into effect March 1, was amended to align with the ODM rule changes regarding IHBT and OhioRISE.