(A) Except as provided in division (B) of this section, the medicaid program shall cover remote ultrasound procedures and remote fetal nonstress tests, utilizing established current procedural terminology codes (CPT codes) for those procedures for when the patient is in a residence or other off-site location from the patient’s medicaid provider.

Terms Used In Ohio Code 5164.092

  • medicaid provider: includes a person or government entity applying for a provider agreement, a former medicaid provider, or both. See Ohio Code 5164.01
  • United States: includes all the states. See Ohio Code 1.59

(B) The coverage under division (A) of this section applies only under the following circumstances:

(1) The medicaid provider responsible for the procedure uses digital technology that meets both of the following criteria:

(a) The technology is used only to collect medical and other data from a patient and electronically transmit that data securely to a health care provider in a different location for that provider’s examination of the data;

(b) The technology has been approved by the United States food and drug administration for remote data acquisition, if required under federal law.

(2) For remote fetal nonstress tests, the CPT code includes a place of service modifier for at home monitoring using remote monitoring solutions that are cleared by the United States food and drug administration for monitoring fetal heart rate, maternal heart rate, and uterine activity.

(C) The department shall adopt rules as necessary to implement this section.

Last updated October 12, 2023 at 11:42 AM