As of June 29, Ohio pharmacies serving Medicaid beneficiaries can submit COVID-19 diagnostic testing claims for reimbursement by the Ohio Department of Medicaid (ODM).
Enabling pharmacies to be reimbursed for COVID testing is just one of several initiatives Ohio Medicaid has implemented since the start of the pandemic. The agency’s goal has been to ensure Medicaid beneficiaries have continued access to health care services while following preventative measures to reduce the risk of spreading the virus.
ODM’s Fee-for-Service (FFS) Pharmacy Point of Sale Vendor Change Healthcare will process all COVID testing claims for Medicaid waiver participants*. Pharmacies serving Medicaid managed care members will bill through each plan’s Pharmacy Benefit Management (PBM) systems. Pharmacies also are encouraged to contact each managed care plan to verify correct use of billing codes and claims processing.
*NOTE: COVID-19 testing performed on behalf of MyCare waiver beneficiaries is covered by Medicare.
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