Pregnancy & Prenatal Information
Prenatal Risk Assessment Form (PRAF)
A complete PRAF helps Moms receive the best support for a healthy pregnancy
(You can download this PRAF information (PDF) if needed.)
Provider Benefits of submitting a PRAF
The electronic PRAF 2.0 has multiple benefits with one, simple submission:
- Automatically notifies the Ohio Department of Job and Family Services County Office, Managed Care Plan, and Home Health Care provider of the pregnancy, need for progesterone and any other need indicated on the form.
- Allows for an Ohio Board of Pharmacy approved Progesterone prescription to be printed and faxed to the appropriate pharmacy.
- Allows provider staff updates by multiple users prior to submission.
- Maintains a pregnant woman’s Medicaid eligibility without disruption in coverage-equating to prompt provider payment for services throughout mom’s pregnancy.
After completing the PRAF, submit a claim based on the guidelines below
| Code + modifier | Description | Fee Schedule Amount* |
|---|---|---|
| H1000 33 | Electronic PRAF submission | $90.00 |
| H1000 | Paper/Faxed version | $12.11 |
*Providers contracted rate would be applied to the fee schedule amount to determine final payment. Health Plans will pay no additional incentives for PRAF submissions.
Note: The following codes are terminated as of June 30, 2021: 59899 U1, 59899 U2 and 59899 U3.
Ensuring Prompt Care
Every pregnant woman with Medicaid coverage should be linked to needed services on her very first prenatal visit. An online PRAF 2.0 submission ensures:
- Medicaid coverage for Mom and baby without disruption through the immediate post-partum period.
- Serves as pregnancy notification to managed care plans and initiation of timely health care and connection to added resources, like care management, important for at-risk pregnancies.
2023 Electronic Pregnancy Risk Assessment Form (ePRAF) Sustainability Interventions
Submitting the PRAF 2.0 using NurtureOhio is Easy!
- Open the NurtureOhio website to access the PRAF
- Instructions can be found at PRAF Provider User Guide
- Users must be registered in the PNM System
- Difficulties with NurtureOhio email: MomsAndBabies@medicaid.ohio.gov
Questions? Contact Provider Services at: 866.296.8731
The Ohio PRAF (Pregnancy Risk Assessment Form) provides vital information to Ohio’s managed care plans. It lets us use our resources in the best way to help pregnant Medicaid recipients.
Additionally the health plans can move more quickly to assisting with any progesterone needs in patient who could benefit and reduce their risk of preterm delivery.
Please see the Ohio Department of Health’s Progesterone Toolkit- Progesterone Messaging Toolkit | Ohio Department of Health and the Ohio Perinatal Quality Collaborative (OPQC) site- Prematurity Prevention — OPQC (squarespace.com)- for more information.