Pursuant to Ohio Revised Code 5160.34, the Ohio Department of Medicaid (ODM) has consolidated links to Medicaid prior authorization requirements. All changes to prior authorization requirements for ODM-administered services and Managed Care Organization-administered services can be accessed via links on this web page.
Fee for Service
- Entering a Prior Authorization
- Prior Authorization Error Message
- Services Provided in an Ambulatory Surgical Center
- Services Provided in an Inpatient Hospital
- Services Provided in an Outpatient Hospital
Instructions to Access Behavioral Health Prior Authorization Requirements:
In the behavioral health (BH) benefit package, there are services and/or levels of care that are subject to prior authorization. The BH prior authorization policy is outlined in the BH Provider Manual and can be accessed by following the instructions below.
- Access the BH Provider Manuals, Rates and Resources webpage here.
- Under the “Manuals” heading, click on the blue “Behavioral Health Provider Manual” text.
- Scroll down to the table of contents. Referencing the table of contents, find the entry for “Table 1-5: Prior Authorization”.
- Click the text: Table 1-5: Prior Authorization.
- Table 1-5 summarizes the BH services/levels of care and their associated prior authorization policy.