July 26, 2022

Ohio Medicaid coverage of chiropractor evaluation and management services

As required by House Bill (HB) 136 as passed by the 134th General Assembly, Medicaid coverage is being established for evaluation and management (E&M) services performed by a chiropractor.

Effective June 13, 2022, the Ohio Department of Medicaid (ODM) will cover low- and moderate-level E&M services represented by CPT® codes 99202, 99203, 99211, 99212 and 99213 when performed by a chiropractor (Provider Type 27). ODM will cover 3 E&M services per benefit year. These changes will be reflected in updates to Ohio Administrative Code (OAC) rule 5160-8-11, entitled “Spinal manipulation and related diagnostic imaging services,” currently targeted to be effective Oct. 1, 2022.

This information is being distributed at the request of the Ohio Department of Medicaid.