Ohio Admin. Code 5160-43-08 - Specialized recovery services program billing procedures and payment rates for recovery management

(A) Definitions of terms used for billing and calculating rates.
(1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement.
(2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered.
(B) Payment rates for individualized placement and support - supported employment and peer recovery support services may be found in rule 5160-27-03 and rule 5160-1-60 of the Administrative Code.
(C) Recovery management billing code table.

Column 1

Column 2

Column 3

Column 4

Billing code


Unit rate

Billing unit


Recovery management

$ 19.00

15 minutes

(D) Claims shall be submitted to ODM via the medicaid information technology system (MITS), and paid in accordance with Chapter 5160-1 of the Administrative Code.


Ohio Admin. Code 5160-43-08
Effective: 10/15/2021
Five Year Review (FYR) Dates: 7/23/2021 and 10/15/2026
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02, 5164.03
Prior Effective Dates: 08/01/2016, 07/01/2017

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