Rule 5160-27-01 | Eligible provider of community behavioral health services.
(A) For the purposes of this chapter, an "eligible billing provider" is an entity that meets the conditions in paragraph (A)(1) or (A)(2) of this rule. An "eligible rendering provider" is an individual who meets one or more of the conditions stated in paragraphs (A)(3) to (A)(8) of this rule and is employed by or under contract with an eligible billing provider.
(1) An entity certified by the Ohio department of mental health and addiction services operating in accordance with sections 5119.35 and 5119.36 of the Revised Code and Chapters 5122-24 to 5122-29 and Chapter 5160-1 of the Administrative Code and providing mental health or substance use disorder treatment services.
(2) An out-of-state entity furnishing mental health and/or substance use disorder services and operating in accordance with rule 5160-1-11 of the Administrative Code.
(3) Physician or physician assistant in accordance with agency 4731 and agency 4730 of the Administrative Code, respectively, and Chapter 5160-4 of the Administrative Code, or a clinical nurse specialist or certified nurse practitioner, as described in Chapter 4723. of the Revised Code.
(4) Registered nurse or licensed practical nurse as defined in section 4723.01 of the Revised Code and working under an order authorized by one of the practitioners listed in paragraph (A)(3) of this rule, except as allowable in accordance with section 4723.01 of the Revised Code or rule 5160-27-11 of the Administrative Code.
(5) A practitioner type described in rule 5160-8-05 of the Administrative Code.
(6) An unlicensed practitioner who operates under general supervision, as described in rule 5160-8-05 of the Administrative Code, of one of the practitioners listed in paragraphs (D)(1) to (D)(17) of this rule and meets the requirements for one of the following practitioner types:
(a) A qualified mental health specialist providing mental health services who:
(i) Meets the requirements for a qualified behavioral health specialist in accordance with agency 5122 of the Administrative Code,
(ii) Holds a valid high school diploma or equivalent, and
(iii) Has both work experience and training related to the service(s) being provided.
(b) A care management specialist providing substance use disorder services who:
(i) Meets the requirements for a qualified behavioral health specialist in accordance with agency 5122 of the Administrative Code,
(ii) Is eighteen years of age or older and has a high school diploma or equivalent, and
(iii) Has an understanding of substance use disorder treatment and recovery including how to engage a person in treatment and recovery.
(7) A pharmacist operating in accordance with rule 5160-8-52 of the Administrative Code.
(8) A certified peer supporter operating in accordance with rule 5122-29-15.1 of the Administrative Code.
(B) All practitioners will practice within their professional scope of practice.
(C) Supervisors will ensure that individuals whom they supervise meet the appropriate education and training qualifications for the service(s) they render.
(D) The following practitioners operating within their scope of practice, licensure, or certification, and in accordance with any service-specific supervison requirements may supervise:
(1) Physician.
(2) Physician assistant.
(3) Certified nurse practitioner.
(4) Clinical nurse specialist.
(5) Psychologist.
(6) Board licensed school psychologist.
(7) Licensed independent social worker.
(8) Licensed professional clinical counselor.
(9) Licensed independent marriage and family therapist.
(10) Licensed independent chemical dependency counselor.
(11) Registered nurse.
(12) Licensed marriage and family therapist.
(13) Licensed chemical dependency counselor II.
(14) Licensed chemical dependency counselor III.
(15) Licensed professional counselor.
(16) Licensed social worker.
(17) Certified peer supporter as defined in rule 5122-29-15.1 of the Administrative Code.
Last updated October 1, 2024 at 9:23 AM
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