Achieve accurate reimbursements for behavioral health claims

Please be advised that Anthem follows the Ohio Department of Medicaid (ODM) billing guidelines. We require the appropriate rendering practitioner modifier to ensure accurate reimbursement of all behavioral health claims. If the rendering practitioner modifier is incorrect or omitted, the claim may not be accepted or could be reimbursed at an incorrect rate. Providers should ensure the pricing modifier is appended first.

For more information on billing guidelines, please refer to the most recent Behavioral Health Provider Reimbursement Manual at medicaid.ohio.gov/resources‑for-providers/bh.

If you have any additional questions, please reach out to your provider relationship account management associate or email OhioMedicaidProvider@anthem.com.