Billing

TCM Reimbursements: Who Qualifies?

Who qualifies for TCM Reimbursement?

  • Medicaid eligible individuals aged three and above, who are deemed eligible for county board services as per section 5126.01 of the Ohio Revised Codes.
  • Medicaid eligible individuals, regardless of age, enrolled on a HCBS waiver administered by DODD.

Who does not qualify for TCM Reimbursement?

  • Individuals under the age of three who do not have an HCBS waiver.
  • Individuals residing in an institution are not reimbursable except the last 180 consecutive days of residence are reimbursable when the activities are related to moving the eligible individual from an institution to a non-institutional community setting.

Should you have any questions or require further clarification regarding eligibility, please do not hesitate to reach out to us.

If you have questions about anything TCM-related, please contact us at TCMTeam@medicaidbillingsolutions.com.