Ohio Medicaid Counseling Fee Schedule: Where to Look

For the Ohio Medicaid counseling fee schedule, start with ODM’s Fee Schedule & Rates entry and choose the resource for your provider setting. For certified community behavioral health agencies, use the Behavioral Health Manuals, Rates and Resources index. Independent practice and a certified agency do not use an interchangeable pricing reference.

This guide locates official sources for codes such as 90791, 90832, 90834 and 90837 without republishing rates. Sources were checked October 9, 2026. Keep the schedule edition and service date with any rate research.

Independent practice versus certified community behavioral health

ODM’s provider page directs independent behavioral health providers who are not certified community agencies to rule 5160-8-05 and Non-Institutional Services fee schedules. It separately directs certified community providers to Chapter 5160-27 and the behavioral health manuals. ODM provider-setting distinctions.

The current manual calls the certifying agency the Ohio Department of Behavioral Health (DBH), formerly OhioMHAS. Its introduction defines the community-provider scope and directs managed care billing questions to the applicable MCE manual. BH Manual v1.28.1, introduction.

Identify which enrolled provider setting will bill the service before looking up an amount. A therapy code appearing in an agency manual does not establish that an independent practice can bill it under the same conditions.

Find the code in the applicable dated source

1. Open the current official schedule index and select the applicable provider/service category.

2. Read the edition and effective-date information before searching a code.

3. For community behavioral health, use the diagnostic-evaluation and individual-psychotherapy sections of the applicable manual.

4. Read the entire applicable row and notes, including practitioner type, modifiers, units and place-of-service conditions.

The March 24, 2026 manual contains diagnostic-evaluation code 90791 in Table 2-7 and individual psychotherapy codes 90832, 90834 and 90837 in Table 3-2. Use those as search locations, not as an instruction to bill a particular code or a reproduced rate table. Official community BH manual.

ODM’s April 2, 2026 update confirms publication of version 1.28.1 and updates to the coding workbook and dual-licensure grid. Recheck the official index for later revisions before using a saved copy. ODM resource-update bulletin.

Check practitioner, supervision and service requirements

For independent-provider services, read rule 5160-8-05 for enrollment, scope and supervision requirements. For community behavioral health reimbursement, read rule 5160-27-03 alongside its applicable appendix and manual. A price lookup alone does not establish covered service or provider eligibility.

The existing Ohio therapist license-tier guide provides background on license distinctions. For a particular claim, use the current rule and applicable schedule rather than carrying a percentage or modifier from an older article into a different provider setting.

A state fee schedule does not settle the MCO payment

The community manual describes FFS coverage and reimbursement and tells providers to use an MCE’s billing manual for MCE-specific information. OhioRISE’s claims page says payments are adjudicated in accordance with the Provider Agreement. Review your actual product and agreement when checking an expected plan payment. OhioRISE payment and agreement guidance.

For a plan payment question, gather the executed agreement or applicable payment terms, service date, code, units, submitted modifiers and remittance result. Ask the plan to identify the payment methodology it applied before assuming a difference from a state reference is an underpayment.

Keep telehealth, authorization and routing checks connected

For a remote visit, use the existing Ohio telehealth billing guide and current plan instructions. For service approval, use the 2026 behavioral health authorization guide. A code’s presence in a fee schedule does not settle either question.

For the claim destination, see the MCO and OhioRISE payer-ID guide. Save the official source, edition and lookup context in the practice’s secure billing workflow so a later payment review can reproduce the research.

How Bomi can help

Bomi can help organize payer follow-up, enrollment maintenance and billing work. Contact Bomi with the workflow you need help resolving.

Related Ohio provider guides

OhioRISE network participation. State enrollment maintenance in PNM.

Frequently Asked Questions

Where is the Ohio Medicaid counseling fee schedule?

Use ODM’s Fee Schedule & Rates entry for the applicable provider setting. ODM directs independent BH providers to Non-Institutional Services; certified community agencies use the behavioral health manuals and Chapter 5160-27 resources.

Where can I find 90837 in the community behavioral health manual?

The March 24, 2026 v1.28.1 manual places 90837 with individual psychotherapy in Table 3-2. Read the practitioner, modifier, unit and service conditions and recheck for later official editions.

Does an Ohio state fee schedule guarantee my MCO payment?

Do not use a state reference alone to settle a plan-payment question. Check the member’s product, applicable provider agreement, plan billing rules and remittance result.