BEHAVIORAL HEALTH SERVICES PROVIDER IN OHIO

PROMOTING MENTAL WELL-BEING AND EMOTIONAL STABILITY THROUGH PERSON-CENTERED SUPPORTS

Behavioral Health Services in Ohio provide individuals with mental health conditions, developmental disabilities, or co-occurring disorders access to professional counseling, therapeutic supports, and behavioral interventions. These services are vital to improving functioning, reducing crisis episodes, and enabling individuals to thrive in home and community settings. Behavioral Health Services are authorized under Ohio Medicaid Home and Community-Based Services (HCBS) Waiver programs and state plan behavioral health programs.

1. GOVERNING AGENCIES

Agency: Ohio Department of Medicaid (ODM)

Role: Oversees Medicaid funding, billing processes, and state plan behavioral health services.

Agency: Ohio Department of Mental Health and Addiction Services (OhioMHAS)

Role: Licenses community behavioral health agencies and monitors clinical service delivery standards.

Agency: Ohio Department of Developmental Disabilities (DODD)**

Role: Coordinates behavioral support services for individuals enrolled in developmental disability waivers.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Provides federal oversight for Medicaid-funded behavioral health services to ensure quality, safety, and person-centered planning.

2. BEHAVIORAL HEALTH SERVICES OVERVIEW

Behavioral Health Services address mental and emotional health needs through individualized, evidence-based care. Services may be delivered in the individual’s home, a clinical setting, or the community.

Approved providers may deliver:

• Individual and Group Therapy: Licensed therapists provide therapeutic interventions for depression, anxiety, PTSD, and more.

• Behavior Support Services: Assessment and development of behavior plans to reduce harmful or disruptive behaviors.

• Case Management: Assisting individuals with accessing services, coordinating care, and connecting to resources.

• Crisis Intervention and Stabilization: Immediate response during behavioral or psychiatric crises.

• Substance Use Counseling: Recovery planning, relapse prevention, and dual diagnosis support.

• Community Psychiatric Supportive Treatment (CPST): In-home and community-based behavioral support.

• Medication Management: Psychiatric evaluation and ongoing monitoring of prescribed medications.

• Peer Support Services: Individuals with lived experience providing recovery-oriented guidance.

• Documentation: Maintaining clinical notes, treatment plans, progress notes, and Medicaid billing logs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Ohio Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Apply for licensure as a Community Behavioral Health Agency (CBHA) through OhioMHAS.

• Enroll as a Medicaid provider through the Ohio Medicaid Provider Enrollment Portal.

• Maintain general liability and professional liability insurance.

• Develop policies for clinical treatment, safety protocols, HIPAA compliance, and documentation.

• Ensure all clinical staff are licensed and complete criminal background checks.

4. OHIO PROVIDER ENROLLMENT PROCESS

Initial Licensing:

• Apply through the OhioMHAS Provider Portal to become a licensed behavioral health provider.

Documentation Submission:

• Submit governance documents, clinical protocols, policy manuals, insurance, and staff credentials.

Readiness Review:

• OhioMHAS conducts an initial site visit and service readiness evaluation.

Medicaid Enrollment:

• Upon approval, apply through ODM’s Provider Enrollment Portal to bill for Medicaid-funded services.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Registration

• IRS EIN confirmation

• NPI registration

• Liability insurance certificates

• OhioMHAS Behavioral Health Agency License

• Behavioral Health Services Policy & Procedure Manual including:

  • Diagnostic assessments and service planning protocols

  • Behavioral crisis response and de-escalation policies

  • Staff credentialing and continuing education logs

  • HIPAA and participant rights documentation

  • Clinical documentation, audit tracking, and billing procedures

  • Incident reporting and client grievance protocols

  • Quality assurance and compliance monitoring tools

6. STAFFING REQUIREMENTS

Role: Clinical Director / Behavioral Health Program Administrator

Requirements: Independent license (LISW-S, LPCC-S, IMFT-S, or similar); administrative and supervisory experience.

Role: Licensed Behavioral Health Providers

Requirements: LSW, LPC, MFT, or higher; trained in evidence-based therapeutic modalities.

Role: Psychiatric Prescribers (as applicable)Requirements: Licensed psychiatrist or psychiatric nurse practitioner (PMHNP).

Role: Behavioral Specialists / Technicians

Requirements: Bachelor’s degree in psychology, social work, or related field; trained in behavior intervention.

Role: Peer Support Workers

Requirements: Certification as Peer Recovery Supporter (OhioMHAS); lived experience in recovery.

All staff must complete:

• HIPAA and participant rights training

• De-escalation and crisis prevention modules

• Documentation and Medicaid billing education

• Annual performance evaluations and continuing education

7. MEDICAID WAIVER PROGRAMS

Behavioral Health Services are available through:

• Individual Options (IO) Waiver – via DODD

• SELF Waiver – behavioral supports

• Level One Waiver – limited behavioral consultation

• Ohio Home Care Waiver – mental health and behavioral health services

• PASSPORT Waiver – for older adults with behavioral health needs

• State Plan Behavioral Health (Medicaid) – broader mental health services available to eligible individuals outside waiver enrollment

• MyCare Ohio – integrated behavioral health through managed care organizations

8. TIMELINE TO LAUNCH

Phase: Business Registration and Policy Development

Timeline: 1–2 months

Phase: Licensing Application and Staff Onboarding

Timeline: 2–3 months

Phase: OhioMHAS Readiness Review and Certification

Timeline: 60–90 days

Phase: Medicaid Enrollment and Billing Activation

Timeline: 30–45 days

9. CONTACT INFORMATION

Ohio Department of Mental Health and Addiction Services (OhioMHAS)

Website: https://mha.ohio.gov

Ohio Department of Medicaid (ODM)

Website: https://medicaid.ohio.gov

Ohio Department of Developmental Disabilities (DODD)

Website: https://dodd.ohio.gov

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — OHIO BEHAVIORAL HEALTH SERVICES PROVIDER

WCG supports new and existing agencies in launching Medicaid-compliant Behavioral Health Services in Ohio, including:

Scope of Work:

• Business setup and OhioMHAS licensure support

• Medicaid enrollment and clinical documentation systems

• Policy manual development for mental health and behavioral service lines

• Staff training and credentialing toolkits

• Medicaid billing setup, service logs, and quality monitoring tools

• Branding, website creation, and referral marketing materials

• Partnership development with waiver teams, health systems, and managed care entities

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.