In preparation for the launch of OhioRISE on July 1, 2022, the Ohio Department of Medicaid developed an OhioRISE Provider Enrollment and Billing Guide. This guide is intended to share policies related to billing for the new and enhanced OhioRISE services. Existing behavioral health services will be covered and will be billed consistent with the billing policies outlined in the BH Provider Billing Manual. This guide can be found here on the OhioRISE website.

Additionally, the ODM released the OhioRISE CME Manual. The ODM and Aetna Better Health of Ohio (Aetna) have developed the OhioRISE CME manual to provide the minimum standards of operation that reflect current policies to which CMEs must adhere. This manual reflects behavioral health care best practices for youth with complex mental health needs. It is grounded in key principles of a Wraparound model and system of care approach. This manual cannot account for every specific situation that will arise during CME services. However, the underlying premise that CME care coordination practice upholds the best interest of the youth and family as planned for through the child family team (CFT) collectively can support any circumstance, including the importance of language. This manual also includes guidance for CMEs to bill for CME-only services. You can find the manual on the OhioRISE website.