Ohio Medicaid Rates: A Guide for Providers and Health Plans

Ohio’s Medicaid program is administered by the Ohio Department of Medicaid (ODM), which publishes fee schedules through a directory at medicaid.ohio.gov, linking out to per-provider-type files by service category.

What’s currently published

As tracked by MedicaidBench, Ohio’s current published rates for a few widely-billed codes include:

• 90791 (initial psychiatric diagnostic evaluation): $130.72 per encounter
• 90837 (individual psychotherapy, ~60 min): $120.36 per session
• 99213 (established-patient office visit): $82.85 per visit
• 99214 (moderate-complexity office visit): $122.27

Effective dates on these vary by code — some reflect a 2019 effective date, others more recent updates — which is itself a useful reminder that “current” doesn’t mean every code was refreshed at the same time. Ohio, like most states, updates individual code categories on their own schedule rather than republishing the entire fee schedule at once.

Format and access

Ohio’s fee schedules are published per provider-type as downloadable CSV and PDF files rather than a single unified spreadsheet, which means locating a specific code sometimes requires knowing which provider-type category it falls under first.

What to watch for

Ohio has been an active state for behavioral health rate policy attention in recent years, given the state’s ABA and psychotherapy billing volume. If you bill behavioral health codes in Ohio specifically, that’s a reasonable category to set an alert rule on rather than only checking primary care or a broader “all codes” rule.

Keeping current

Because ODM doesn’t publish a changelog alongside its fee schedule updates, the only way to know a specific code changed is to compare the new file against what you had before — or to have a system doing that comparison automatically. MedicaidBench tracks Ohio’s fee schedule continuously and logs the source document and effective date behind every rate, so a change shows up the same day it’s detected rather than whenever someone happens to re-check the file.