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

119.03 (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, not to exceed a maximum of 8.5 units of service per month. (B) Payment rates for individualized placement and support - supported employment 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 Column2 Column 3 Column 4 Billing code Service Unitrate Billingunit T1016 Recovery management $27.54 15minutes (D) Claims will be submitted to ODM and reimbursed in accordance with Chapter 5160-1 of the Administrative Code. Last updated August 22, 2025 at 8:12 AM Supplemental Information Authorized By: 5164.02 Amplifies: 5164.02 , 5164.03 10/15/2026 10/15/2021, 9/1/2024