MedicaidPrior AuthMedium impact
[Ohio] Prior Authorization Requirement Update
CareSource·OH·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 13, 2026
Summary
CareSource Ohio Medicaid and MyCare now requires prior authorization for new CMS codes including outpatient service code 0888T and 22 new durable medical equipment codes (Q4312-Q4333), effective January 1, 2025.
Action Required
Immediately: Billing team must update system to require prior authorization for CMS codes 0888T (outpatient services) and Q4312-Q4333 (durable medical equipment) for all CareSource Ohio Medicaid and MyCare patients. Update encounter forms and alert providers. Claims will be denied without prior authorization.