If your organization is planning to provide the new OhioRISE services, ODM requires that providers add a provider specialty to their Medicaid provider enrollment type in order to bill for some new and enhanced services under this program and as part of the Next Generation of Ohio Medicaid.  The OhioRISE Provider Specialties Guide describes what “provider” types must enroll and the required documentation for each service or “specialty”.  The new OhioRISE services that require Medicaid provider enrollment include:

• Child and Adolescent Needs and Strengths (CANS) Assessments. (INDIVIDUAL Practitioner with Ohio CANS Certification);
• Mobile Response and Stabilization Services (MRSS);
• Intensive Home-Based Treatment (IHBT), which includes IHBT, Multi-Systemic Therapy (MST), and Functional Family Therapy (FFT);
• Intensive and Moderate Care Coordination; 
• Behavioral Health Respite; 
• OhioRISE Waiver Transitional Services and Supports; and
• OhioRISE Waiver Out of Home Respite.

IMPORTANT NOTE: With the exception of the CANS Assessment, OhioRISE specialty enrollment is at the provider organization level. You only need to add or update individual Medicaid practitioner enrollment for the certified Ohio CANS Assessors.  All other services/specialties are enrolled under your agency NPI.

Providers must have the appropriate OhioRISE provider specialty added to your Medicaid enrollment in order to bill Medicaid for the new OhioRISE services listed above on and after July 1, 2022. To avoid delays in claims payment after July 1, it is critical for providers to add these specialties as soon as possible.

Current Medicaid Enrolled Providers: If you are a provider who is currently enrolled in ODM and have the appropriate certification or documentation to provide any of the services listed above, please email ODM at [email protected]. Request that the applicable specialty for the new service be added to your existing provider type, include your NPI and Ohio Medicaid ID, and attach required documentation.

New Providers: If you are a provider not currently enrolled in ODM as a Medicaid provider, please visit the Ohio Medicaid online application to start the Medicaid enrollment process. If you would like to add more than one OhioRISE specialty, please email ODM after your enrollment is complete at [email protected] to submit the required documentation for the new OhioRISE specialties.