IHBT Enhancements in Preparation for OhioRISE

Effective March 1, 2022, the Ohio Department of Medicaid (ODM) and the Ohio Department of Mental Health and Addiction Services (OhioMHAS) will implement enhancements to the Intensive Home-Based Treatment (IHBT) service in accordance with new Ohio Administrative Code (OAC) rules 5122-29-28 and 5160-27-05. Medicaid billing and claims processing changes to be implemented for dates of service on and after March 1, 2022, include:

  • Updates to Medicaid payment rates, including new practitioner-specific rates.
  • The addition of qualified mental health specialists and peer supporters as eligible rendering providers of IHBT.
  • New billing codes and rates specific to Multi-Systemic Therapy (MST) and Functional Family Therapy (FFT).
  • Updates to diagnosis code requirements to include any valid ICD-10 diagnosis code for youth who meet the criteria described in new OAC rule 5122-29-28. (See “ICD-10 DX code groups” at Medicaid.Ohio.Gov under Provider > Manuals, Rates & Resources).
  • Changes have been made, as authorized in OAC rule 5160-27-05, to the list of behavioral health services that are allowed to be rendered to a youth receiving IHBT, MST, or FFT. (See the “ACT/IHBT” Excel spreadsheet at Medicaid.Ohio.Gov under Provider > Manuals, Rates & Resources.)
  • IHBT services (including MST and FFT) will continue to be prior authorized and paid by the current Medicaid-managed care plans and ODM for fee-for-service members. Previous authorizations for IHBT will remain in effect.
  • ODM and the managed care plans will be ready to begin accepting and processing claims with these changes on March 1, 2022. After the OhioRISE program is implemented July 1, 2022, IHBT services will be available only through the OhioRISE program. More information about the transition of youth into OhioRISE will be shared in the coming months.

ODM updated the Behavioral Health Provider Manual to incorporate these changes. Please see the detailed chart of practitioners, billing codes, and rates on Table 3-15 on page 77.

Certification for IHBT is required to bill the codes and there are additional requirements for FFT and MST in the updated MHAS IHBT rule. Please send any questions about these changes to [email protected].