Billing guidelines for Medicaid behavioral health providers

Please be advised Anthem follows the Ohio Department of Medicaid (ODM) billing guidelines. To ensure accurate reimbursement of all behavioral health claims, Anthem requires the appropriate rendering practitioner modifier. If the rendering practitioner modifier is incorrect or omitted, the claim may be denied or paid at the incorrect rate.

For more information on the billing guidelines, please see 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.