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Increased Medicaid Rates to Take Effect This Month for Ohio Providers

Client Alert
January 5, 2024

As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024. The rate increases total roughly $3.4 billion per year and apply to the following types of providers:

  • Non-institutional providers:
    • Ambulatory surgical centers / dialysis
    • Testing / lab / X-ray / durable medical equipment
    • Physicians / advanced practice registered nurses / physician assistants / clinics / skilled therapy
    • Vision and eye care
  • Community behavioral health providers
  • State plan private duty nursing / home health providers
  • Home and Community Based Services waiver providers:
    • PASSPORT waiver providers
    • Assisted living waiver providers
    • Ohio home care waiver providers
    • MyCare Ohio waiver providers
    • Individual Options waiver
    • Level 1 waiver providers
    • Self-Empowered Life Funding (SELF) waiver providers
  • Department of Developmental Disabilities providers

Beginning on January 1, 2024, the majority of the codes in the Ohio Medicaid fee schedule for non-institutional providers increased by 5% or more. Specifically, there was approximately a 5% increase for physicians, APRNs, PAs, clinics, skilled therapy providers, ambulatory surgical centers, laboratories, dialysis providers, X-ray providers, and DME providers. Additionally, there was a 5.7% dispensing fee rate increase for pharmacies, a 79% rate increase for transportation providers, and a 93% rate increase for dental providers. There was no rate increase for FQHCs. However, there was a 10% baseline rate increase for community behavioral health rates.

The increased reimbursement rates authorized by HB 33 apply to dates of service starting January 1, 2024, and beyond. Note that ODM will reimburse all services based on the date the service was rendered, not the date the provider bills for the service. ODM also reminded providers that, even after the rates are increased due to HB 33, providers must continue to charge their reasonable and customary rates regardless of anticipated reimbursement from the department. ODM’s fee schedules and rates are codified in the Ohio Administrative Code and accessible for providers on ODM’s website.

If you have questions about ODM’s reimbursement rate increases, please contact your local BMD Healthcare Attorneys Daphne Kackloudis at dlkackloudis@bmdllc.com or Ashley Watson at abwatson@bmdllc.com.

Daphne KackloudisAshley Watsonjordan burdickMedicaid
Client Alert

Supreme Court Clears Path for TPS Terminations: What Employers Need to Know

June 25, 2026The U.S. Supreme Court's June 25, 2026 decision in Mullin v. Doe and Trump v. Miot removed legal obstacles that had delayed the termination of Temporary Protected Status (TPS) for Haiti and Syria. The ruling also reinforces the administration's authority to terminate other TPS designations currently under review. Employers should immediately identify workers whose employment authorization is tied to affected TPS programs, review Form I-9 records, and prepare for forthcoming USCIS guidance before taking any employment action.Client Alert

The Risks of Outsourcing Medical Billing and the Importance of State-Law Compliance

June 24, 2026Offshoring medical billing and other administrative functions can reduce costs, but it also raises significant compliance, operational, and contractual risks. Although HIPAA does not explicitly prohibit protected health information from being accessed or stored outside the United States, healthcare providers and their vendors remain responsible for safeguarding patient information and complying with state-specific restrictions that may limit or prohibit offshore subcontracting.Client Alert

Risks of Using AI-Generated, Implied Celebrity Endorsements in Advertising

June 3, 2026Businesses using AI-generated celebrity images, videos, or voice simulations in advertising may face significant legal risks if the content falsely implies an endorsement, affiliation, or sponsorship. This article discusses potential exposure under false advertising, right of publicity, consumer protection, and professional conduct laws, and explains why disclaimers may not be enough to avoid liability.Client Alert

CMS Requires Providers to Use an Updated Advance Beneficiary Notice (ABN) Form by May 12, 2026

May 22, 2026CMS has released an updated Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, that all providers and suppliers must begin using by May 12, 2026. The revised form includes clearer language and formatting updates intended to improve patient understanding and compliance.Client Alert

CMS and Ohio Ramp Up Fraud Enforcement in Home Health and Hospice

May 15, 2026CMS and Ohio have launched sweeping new fraud prevention initiatives targeting home health and hospice providers, signaling a period of heightened scrutiny for enrollment, billing, documentation, and EVV compliance. While aimed at combating fraud, these measures also create significant operational and due process risks for compliant agencies, making proactive compliance programs, auditing, and governance more important than ever.
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