These reimbursement policies apply to our Ohio Medicaid plan.
Reimbursement policies are designed to assist you when submitting claims to CareSource. They are routinely updated to promote accurate coding and policy clarification. These proprietary policies are not a guarantee of payment. Payments for claims may be subject to limitations and/or qualifications. Payment will be determined based upon a review of the actual services provided to a member and will be determined when the claim is received for processing. Providers and their office staff are encouraged to use self-service channels to verify member eligibility.
The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.
Current Reimbursement Policies
- Medical Drug Reimbursement Rates
- Molecular Diagnostic Testing for Gastrointestinal Illness
- Molecular Diagnostic Testing for Hepatitis B and C
- Molecular Diagnostic Testing for Influenza Virus Infection
- Molecular Diagnostic Testing for Respiratory Virus
- Molecular Diagnostic Testing for Streptococcus A and B Infection
- Telemedicine Services
- Telemedicine Services - COVID-19 State of Emergency Provider Guide Statement on Telehealth
- Telemedicine Services - COVID-19 Temporary Telehealth Services Guidance
- Three-Day Payment Window
- Thyroid Testing
- Transcutaneous Electrical Nerve Stimulation (TENS)
- Trigger Point Injections