View the Ohio Medicaid Provider Profile

The Medicaid Provider Profile page shows the Medicaid services provided by your facility, along with the values and effective dates of Medicaid reimbursement calculations.

To access the Medicaid Provider Profile page, select Go To > Government Payor Research > Medicaid > Provider Profile. The Medicaid Provider Profile page opens.
In the Select State or Payer drop down list, select OH.
Select Go.
Enter the provider’s tax ID or ten-digit National Provider Identification (NPI) number for the provider you want to review in the NPI or Provider Number field.
Enter a date in the Effective Date field if you want to view provider profile information for an effective date other than today.
Click Display Profile. The Medicaid Provider Profile information displays.
Note: To clear the results and return to original Medicaid Provider Profile page, click Reset.
Review your Medicaid Provider Profile information.

Note: The data that displays on the provider profile varies from state to state.

Ohio Medicaid Provider Profile

The following table describes each of the fields on the Medicaid Provider Profile page for Ohio Medicaid.

Field	Description
State or Payer	State or payer for the selected provider number
NPI or Provider Number	Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims
Effective Date	Date on which the selected profile went into effect
Hospital Classification
Nursery Level	Nursery level as determined by the Ohio Department of Health
Distinct Part Psych	Indicates whether the facility meets Psych classification as determined by Medicare
Teaching Hospital	Indicates whether the facility meets teaching criteria as determined by the Ohio Administrative Code
High Outlier Hospital	Indicates whether the facility meets the high outlier criteria as determined by the Ohio Administrative Code
Cost Outlier Hospital	Indicates whether the facility meets the cost outlier criteria as determined by the Ohio Administrative Code
High HIV Discharge Hospital	Indicates whether the facility HIV discharges exceed criteria outlined in the Ohio Administrative Code
Inpatient Acute Hospital
DRG/PPS Base Rate	DRG base rate as determined by the Ohio Administrative Code
Capital Allowance	An additional payment based on capital expenses as outlined in the Ohio Administrative Code
Educational Allowance	An additional payment based on the expenses related to medical education
Cost-To-Charge Ratio	The ratio for determining hospital cost based on charges
Outpatient Acute Hospital - Non EAPG
Cost-To-Charge Ratio	The ratio for determining hospital cost based on charges
EAPG
Grouper Type	The type of grouper used for this profile.
Grouper Version	The DRG grouper version used for this profile.
Payer Exception	Identifies the payer exception.
Base Rate	State determined, Facility specific Base Rate used for standard EAPG Payment.
Cost to Charge Ration	The ratio for determining hospital cost based on charges.
User Defined Adjustment Factor	Facility specific adjustment factor for payments.
Hospital Type	Identifies the hospital type.