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Rule 5160-46-06.1 | Ohio home care waiver program: home care attendant services reimbursement rates and billing procedures
OhioregulationOhio Department of Medicaid· effective 2024-01-01
What this rule requires your agency to do
- 1HCAS provided in a group setting (two or three individuals at the same address) is reimbursed at the group rate rather than the standard rate.(Rule 5160-46-06.1 | Ohio home care waiver program: home care attendant services reimbursement rates and billing procedures)
- 2For HCAS visits less than or equal to 15 minutes, Ohio medicaid reimburses a maximum of one unit; for 16 through 34 minutes, a maximum of two units.(Rule 5160-46-06.1 | Ohio home care waiver program: home care attendant services reimbursement rates and billing procedures)
- 3HCAS providers must use the applicable two-alpha-numeric-digit modifier to provide additional information regarding service delivery when billing.(Rule 5160-46-06.1 | Ohio home care waiver program: home care attendant services reimbursement rates and billing procedures)
- 4An HCAS visit may not exceed twelve hours or forty-eight units in duration.(Rule 5160-46-06.1 | Ohio home care waiver program: home care attendant services reimbursement rates and billing procedures)
Applies to: personal care
OAC rule defining the base rate, unit rate, group rate, modifiers, and visit-duration billing rules for home care attendant services (HCAS) under the Ohio Home Care waiver.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.