Provider Reimbursement and Rate Setting

The Provider Reimbursement unit is concerned with the amount Arkansas Medicaid providers are paid for their services. It

  • develops reimbursement methodologies and rates
  • determines the impact of changes in reimbursement on Arkansas Medicaid’s budget
  • coordinates payments with Arkansas Medicaid’s fiscal agent
  • provides technical assistance to providers about reimbursement

Provider Reimbursement processes all necessary cost settlements for institutional providers (such as hospitals, residential treatment units, and rural health clinics) and long-term care facilities. It maintains reimbursement rates and assigns all billing codes for institutional and noninstitutional per diems, services, supplies, and equipment rentals and purchases. It also reviews cost reports submitted by long-term care facilities and maintains a database of cost-report information.