Update to communication sent on 4/30/26 - effective date changed to 6/1/26.

 

Dear AmeriHealth Caritas Ohio Provider,

This notice is to inform you of updates to AmeriHealth Caritas Ohio claims system configuration, effective June 1, 2026. This updates aligns with the language in the Ohio Department of Medicaid Behavioral Health Provider Manual published on March 24, 2026 (see pages 82 and 83 of the ODM BH Provider Manual for details).

 

Please be advised that per the ODM BH Provider Manual the following codes cannot be billed on the same day as substance use intensive outpatient code (H0015) or the partial hospitalization code (H0015 TG). This applies even if the services are billed on the same day by different providers.

• H2020
• H2012 (over 1 hour)
• H0038 HQ (over 4 units)
• 90853 (over 1 hour)
• 90849 (over 1 hour)
• H0005 (over 4 units)
• H0036 HQ (over 4 units)
• H2019 HQ (over 4 units
• T1002 HQ (over 4 units)

Claims dated for services rendered after June 1, 2026, will be processed in alignment with the ODM Behavioral Health Provider Manual; AmeriHealth Caritas Ohio will NOT be retroactively reviewing previous payments.

 

We encourage you to review your billing practices to ensure compliance with these changes. If you have any questions, please refer to the Behavioral Health Provider Manual or contact our provider services team for assistance at 1-833-644-6001. You can also reach out directly to your account executive via email OhioProviderServices@amerihealthcaritasoh.com.