Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-15 - Medical Transportation Services
Section 5160-15-21 - Transportation: services from an eligible provider: conditions of provider participation
Universal Citation: OH Admin Code 5160-15-21
Current through all regulations passed and filed through September 16, 2024
(A) Definition. "Eligible provider" has the same meaning as in rule 5160-1-17 of the Administrative Code.
(B) Transportation-specific criteria. For each entity enrolled as an eligible provider of transportation services, the following conditions are met:
(1)
The entity, each crew member, and each attendant comply
with all applicable local, state, and federal laws, regulations, and rules,
including all applicable provisions developed in accordance with Chapter 4765.
or Chapter 4766. of the Revised Code;
(2)
Each vehicle
meets all applicable permit provisions developed in accordance with Chapter
4766. of the Revised Code; and
(3)
If the entity
provides ground ambulance services, it is also enrolled in medicare as an
ambulance service provider or supplier.
(C) Rendering provider. The following eligible providers may render a transportation service:
(1) A wheelchair van provider;
(2) An ambulance provider;
(3) A hospital; or
(4) A provider under contract with a medicaid
managed care organization.
(D) Billing ("pay to") provider. The following eligible providers may receive medicaid payment for submitting a claim for a transportation service:
(1) A wheelchair van
provider;
(2) An ambulance
provider;
(3) A hospital;
or
(4) A provider under contract
with a medicaid managed care organization.
(E) Prescribing or referring provider.
(1) The following practitioners may certify
the necessity of either a wheelchair van service or an ambulance service:
(a) An advanced practice registered
nurse;
(b) A doctor of medicine,
osteopathy, or podiatric medicine;
(c) A physician assistant; or
(d) Any other professional recognized by the
department as having prescriptive authority.
(2) The following practitioners may certify
the necessity of a wheelchair van service:
(a)
A chiropractor;
(b) A licensed
practical nurse or registered nurse;
(c) An occupational therapist or physical
therapist;
(d) A
psychologist;
(e) A certified
rehabilitation counselor; or
(f)
Any other professional recognized by the department as having the
qualifications necessary to determine whether an individual
needs a mobility device.
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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