# Ohio Admin. Code 5160-59-03.3: Rule 5160-59-03.3. OhioRISE: intensive home-based treatment service > Ohio · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_3 ## Section - **Citation:** Ohio Admin. Code 5160-59-03.3 - **Heading:** Rule 5160-59-03.3. OhioRISE: intensive home-based treatment service - **Jurisdiction:** Ohio - **Kind:** Regulations - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Ohio Administrative Code / Agency 5160 / Chapter 5160-59 / Rule 5160-59-03.3 ## Text 119.03 (A) Scope. This rule sets forth provisions governing medicaid coverage of intensive home-based treatment (IHBT) services. (B) Definition. IHBT is the service and activities as set forth by the Ohio department of mental health and addiction services (OhioMHAS) in rule 5122-29-28 of the Administrative Code. (C) Eligible providers of IHBT services. (1) Providers eligible for medicaid payment for IHBT will: (a) Meet the criteria in paragraph (A)(1) or (A)(2) of rule 5160-27-01 of the Administrative Code; and (b) Provide the service in accordance with rule 5122-29-28 of the Administrative Code. (D) Coverage. (1) Payment may be made for IHBT services rendered face-to-face in person or via telehealth in accordance with rule 5122-29-31 of the Administrative Code. (2) Payment may be made for services rendered by IHBT staff described in rule 5122-29-28 of the Administrative Code that are eligible as a provider of behavioral health services in accordance with rule 5160-27-01 of the Administrative Code. (3) Medicaid rates for services described in this rule are listed in the appendix A to this rule. (E) Limitations. (1) The following activities are not reimbursable as part of IHBT: (a) Time spent doing, attending, or participating in recreational activities. (b) Child care services or services provided as a substitute for the parent or other individual responsible for providing care or supervision. (c) Respite care. (d) Transportation for the youth or family. (e) Any art, movement, dance, drama, or animal therapies, unless incorporated into the IHBT treatment modality. (f) Services provided to teach academic subjects or as a substitute for educational personnel including, but not limited to a teacher, teacher's aide, or an academic tutor ividual responsible for providing care or supervision. (c) Respite care. (d) Transportation for the youth or family. (e) Any art, movement, dance, drama, or animal therapies, unless incorporated into the IHBT treatment modality. (f) Services provided to teach academic subjects or as a substitute for educational personnel including, but not limited to a teacher, teacher's aide, or an academic tutor. (2) A separate medicaid payment will not be made for any of the following services or treatments while the youth is enrolled in IHBT services, unless the service is prior authorized by the OhioRISE plan, or is listed in the child and family-centered care plan: (a) Behavioral health assessments, screenings, and diagnostic evaluations, except of an Ohio children's initiative "child and adolescent needs and strengths" (CANS) assessment completed in accordance with rule 5160-59-03.2 of the Administrative Code that is separately reimbursable. (b) Individual, group, or family psychotherapy and counseling. (c) Therapeutic behavioral services, except for therapeutic behavioral group service - hourly and per diem as defined in rule 5160-27-06 of the Administrative Code. (d) Community psychiatric supportive treatment as described in rule 5122-29-17 of the Administrative Code. (e) Psychosocial rehabilitation as described in rule 5160-27-08 of the Administrative Code. (f) Substance use disorder (SUD) residential treatment services as described in rule 5160-27-09 of the Administrative Code. (g) Assertive community treatment as described in rule 5160-27-04 of the Administrative Code. (h) Stabilization services as defined in rule 5160-27-13 of the Administrative Code and rendered by a mobile response and stabilization service (MRSS) provider in accordance with rule 5160-27-13 of the Administrative Code. (i) SUD targeted case management as described in rule 5160-27-10 of the Administrative Code rtive community treatment as described in rule 5160-27-04 of the Administrative Code. (h) Stabilization services as defined in rule 5160-27-13 of the Administrative Code and rendered by a mobile response and stabilization service (MRSS) provider in accordance with rule 5160-27-13 of the Administrative Code. (i) SUD targeted case management as described in rule 5160-27-10 of the Administrative Code. (3) When the OhioRISE plan denies, reduces, terminates or suspends IHBT, this constitutes an adverse benefit determination, and can be appealed in accordance with rule 5160-26-08.4 of the Administrative Code. View Appendix Last updated August 19, 2024 at 8:26 AM Supplemental Information Authorized By: 5167.02 , 5164.02 Amplifies: 5162.02 , 5162.03 , 5167.04 , 5167.12 , 5167.10 7/1/2027 7/1/2022 ## Nearby sections - [Ohio Admin. Code 5160-59-01 Rule 5160-59-01. OhioRISE: definitions](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_01.md) - [Ohio Admin. Code 5160-59-01.1 Rule 5160-59-01.1. OhioRISE: application of general managed care rules](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_01_1.md) - [Ohio Admin. Code 5160-59-02 Rule 5160-59-02. OhioRISE: eligibility and enrollment](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_02.md) - [Ohio Admin. Code 5160-59-02.1 Rule 5160-59-02.1. OhioRISE: first day eligibility and enrollment](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_02_1.md) - [Ohio Admin. Code 5160-59-03 Rule 5160-59-03. OhioRISE: covered services](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03.md) - [Ohio Admin. Code 5160-59-03.1 Rule 5160-59-03.1. OhioRISE: utilization management](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_1.md) - [Ohio Admin. Code 5160-59-03.2 Rule 5160-59-03.2. OhioRISE: care coordination](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_2.md) - [Ohio Admin. Code 5160-59-03.3 Rule 5160-59-03.3. OhioRISE: intensive home-based treatment service](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_3.md) - [Ohio Admin. Code 5160-59-03.4 Rule 5160-59-03.4. OhioRISE: behavioral health respite service](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_4.md) - [Ohio Admin. Code 5160-59-03.5 Rule 5160-59-03.5. OhioRISE: primary flex funds](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_5.md) - [Ohio Admin. Code 5160-59-03.6 Rule 5160-59-03.6. Psychiatric residential treatment facility (PRTF) service](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_6.md) - [Ohio Admin. Code 5160-59-04 Rule 5160-59-04. OhioRISE home and community-based services waiver: eligibility and enrollment](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_04.md) - [Ohio Admin. Code 5160-59-05 Rule 5160-59-05. OhioRISE home and community-based services waiver: covered services and providers](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_05.md) - [Ohio Admin. Code 5160-59-05.1 Rule 5160-59-05.1. OhioRISE home and community-based services waiver: out-of-home respite](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_05_1.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_59_03_3. 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