Ohio Medicaid: Prior auth requirements for incontinence and respiratory supplies
Durable medical equipment (DME) oxygen systems, ventilators, respiratory assist devices, nebulizers, humidifiers and related therapy devices are a benefit only for members 7 years and older when provided through Medical Services Company.
To request the following respiratory and oxygen system and/or devices, please call Medical Services Company at 800-824-1400:
| Service category | CPT®/HCPCS codes |
| Medical and surgical supplies | A4481, A4483, A4604-A4606, A4608, A4614-A4620, A4623-A4629, A7001-A7010, A7012-A7018, A7020, A7027-A7040, A7044-A7047, A7504, A7507-A7509, A7520-A7522, A7524-A7527 |
| Service category | CPT/HCPCS codes |
| Durable medical equipment | E0424-E0425, E0430-E0431, E0433-E0435, E0439-E0445, E0465-E0466, E0470-E0472, E0480, E0482, E0484, E0550, E0555, E0560-E0562, E0565, E0570, E0572, E0574-E0575, E0580, E0585, E0600-E0601, E1353, E1355-E1356, E1372, E1390-E1392, E1405-E1406, E2000, K0738 |
DME incontinence supplies
Incontinence supplies are a benefit only when provided through Edgepark® Medical Supplies. To request the following incontinence supplies, please call Edgepark Medical Supplies at 844-564-1008.
DME supplies for incontinence and respiratory services require 2 different prior authorization requests.
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CPT® is a registered trademark of the American Medical Association.
PCA-1-26-01061-C&S-NN_06152026
