06/19/2025

Updated Ventilator Rates Effective July 1

The Ohio Department of Medicaid (ODM) has released updated reimbursement rates for nursing facilities participating in the Ventilator and Ventilator Weaning Program, effective July 1, 2025. The rates represent the second consecutive decline in rates, for which LeadingAge Ohio is awaiting clarification since these rates are set based on Long-term Acute Care hospital reimbursement. Additionally, Medicaid has previously promised clarification on non-invasive ventilator service reimbursement. 

For state fiscal year 2026, the daily Medicaid payment will be $1,304.63 for ventilator-dependent residents and $1,565.56 for residents receiving ventilator weaning services. These enhanced rates apply across fee-for-service, MyCare, and managed care populations, including those receiving hospice services.

Facilities must use correct revenue center and diagnosis codes when billing. To apply for participation or add ventilator services, providers must complete form ODM 10227 and submit it to NFPolicy@medicaid.ohio.gov.

Access the full fact sheet and contact NFPolicy@medicaid.ohio.gov with questions.