Key information and reference tools to support your behavioral health startup journey.
Current Ohio Medicaid reimbursement rates for key behavioral health service codes (HB33, effective January 1, 2024). For informational purposes only.
| Service | Billing Code | Unit | OH Medicaid Rate | Notes |
|---|---|---|---|---|
| CPST / Case Management | H0036 | Per 15-min unit | $22.03 | Community-based; requires QMHS |
| TBS Individual | H2019 | Per 15-min unit | See current ODM schedule | Child/youth; requires clinical sup. |
| Day Treatment | H2020 | Per client/day | $153.25 | QMHS + 3 unlicensed staff minimum |
| Psychiatric Evaluation | 90791 | Per session | See current ODM schedule | Requires licensed clinician |
| Individual Therapy | 90837 | Per 60-min session | See current ODM schedule | Requires licensed clinician |
* Rates subject to change. Always verify current rates with the Ohio Department of Medicaid. These figures are provided for educational planning purposes only and do not constitute billing advice.
A high-level overview of the major milestones in launching an Ohio behavioral health agency. This is not exhaustive — specific requirements vary by service type and certification category.
LLC or corporation registered with Ohio Secretary of State; EIN obtained from IRS
Type 2 (organizational) NPI obtained through NPPES
Lease or ownership of compliant clinical office space; ADA compliance reviewed
LISW-S or LPCC-S contracted to fulfill supervision requirements; documentation on file
All required service-line policies developed, reviewed, and adopted by ownership
OMAS application submitted; documentation package complete; site visit scheduled
e-App submitted; standards review complete; QAPI plan in place; survey readiness achieved
License number assigned; certification documentation on file at agency location
Accreditation certificate obtained; posted; QAPI monitoring underway
Ohio Medicaid enrollment application submitted by owner/operator. ADB's consulting engagement concludes prior to this phase.
Ohio Department of Mental Health and Addiction Services — the state agency responsible for CMHC certification and behavioral health licensure.
Visit OhioMHAS ↗Independent accreditation organization that grants BHHS and other accreditations to behavioral health agencies demonstrating standards compliance.
Visit Joint Commission ↗State Medicaid agency responsible for provider enrollment, credentialing, billing, and managed care contracting for Ohio behavioral health providers.
Visit ODM ↗These resources provide a foundation — but every agency's situation is unique. Schedule a consultation and let's talk through yours specifically.
Schedule a Consultation