What’s New for Arkansas Medicaid Providers
Content updated March 1, 2021
The New Provider Workshop is designed for new and established Medicaid providers who need training for the Medicaid program. The MMIS team covers billing and policy information.
Wednesday, March 10, 2021
9:00 a.m. until 1:00 p.m.
Register for the virtual workshop today!
Effective February 24, 2021 Prior Authorization (PA) letters will be linked to the appropriate Prior Authorization request in the HealthCare Portal. To open/view PA letters, access the Prior Authorization request using the search function through the “View Status of Authorizations” link under the Care Management tab. PA letters will no longer be found in Files Exchange.
Effective February 15, 2021, the Provider Enrollment Unit will no longer accept Electronic Fund Transfer (EFT) forms via fax. EFT forms can be uploaded on the provider portal (preferred) or mailed to the address found on the EFT form. For help uploading documents on the portal, view or print the MMIS Job Aid - Uploading Documents (PDF, new window).
If a provider cannot submit an EFT form using the provider portal or by mail, a hardship exception is possible only with DHS approval on a case by case basis.
If you have any questions regarding this notification, please call Provider Enrollment at (800) 457-4454 or (501) 376-2211.
At this time, billing for personal care services through MMIS will continue past January 31, 2021. Providers can continue to bill for these services directly to our MMIS for processing. When a new date is determined, we will make that announcement clarifying the new deadline. Providers are still encouraged to use the AuthentiCare system to ensure comfort with usage and to avoid impact to their claims processing as we transition over to the new system.
A Community Support System Provider (CSSP) is a provider with a CSSP license to provide home- and community-based services. The Division of Provider Services and Quality Assurance (DPSQA) will now license CSSPs as ‘Base’ (PT96/Specialty 04, enrollment type: group) or ‘Enhanced’ (PT96/Specialty C9, enrollment type: group).
A new specialty is also added to Provider Type 95 (Registered, Non-Credentialed Providers) for Community Support Staff (PT95/Specialty CS, enrollment type: Atypical). This new specialty has been added as a choice on Form DMS-7708, Practitioner Identification Number Request Form.
To complete a web application, navigate to Arkansas Medicaid Provider HealthCare Portal
- Click the “Provider” link on the left side of the page to enroll as a provider.
- Click “Enrollment Application” to start a new application.
- Select Enrollment Type of “Group” from the drop-down list displayed. Then select provider type 96 and your specialty then complete the remaining fields displayed and click continue.
If enrolling as the individual, select Enrollment Type of “Atypical”, provider type 95 and specialty CS then complete the remaining fields displayed and click continue.
To complete a paper application
While paper applications are still accepted, it is strongly encouraged for all providers to submit their applications electronically. Paper application processing will be delayed due to staffing shortages caused by COVID-19.
For questions regarding the enrollment process, please contact Gainwell Technologies Provider Enrollment at 1-800-457-4454, locally at 501-376-2211. Thank you in advance for your cooperation and compliance.
Effective December 22, 2020, Arkansas Medicaid will cover Swing Beds (Revenue code 194) at a rate of $400 for the following providers:
- Provider Type 05 - Hospital / Provider Specialty CH - Critical Access Hospital
Provider billing instructions for Swing Beds:
- Claims can be submitted electronic or paper with required attachments
- Attach a cover sheet requesting coverage of Swing Bed in a critical access hospital.
- Revenue Code 194 should be billed for Swing Bed days.
- Bill all dates of service for each month on one claim (there will be separate claims filed for dates of service in different months)
- Bill at the amount of $400 per day.
This is a temporary rule that has been implemented due to bed shortage caused by COVID. The rule will be suspended through the Public Health Emergency as declared by the Governor. Notification of end dating this temporary rule will be announced at a later date.
During Covid-19 CMS stopped conducting compliance reviews completed on the 1527 form. However, CMS recently started conducting compliance reviews again. We have received a lot of concern from Nursing Home providers about their Medicare IDs being terminated for not having their yearly compliance review completed by CMS. During the Covid-19 emergency we will not terminate any provider for not having their compliance review completed. If you have further questions or concerns, please contact the Provider Enrollment Help Desk at 501-301-8311.
Early in the public health emergency, the Centers for Medicare and Medicaid Services announced that it was allowing states to temporarily waive certain federal requirements to help ensure Americans could access care and help hospitals deal with patient surges due to COVID-19. The waiving of rules is called issuing “blanket waivers” of federal requirements. These waivers allow hospitals to use beds as needed and still get reimbursement from Medicaid, with changes described in the Medicaid Policies Regarding Hospital Services During Public Health Emergency fact sheet (Word, new window).
In addition to changes through the blanket waivers, Arkansas Medicaid also temporarily suspended the Medicaid Utilization Management Program review requirement for patients over age 1 after four days of inpatient care. Now, all hospital stays, regardless of length are subject only to retrospective review. This includes transfers between hospitals.
As the threat from COVID-19 continues, important information on what the Arkansas Department of Human Services (DHS) is doing about coronavirus (COVID-19) as well as reliable, up-to-date information about how the virus is affecting the State can be found on the DHS website. Learn more about DHS’s response to COVID-19. (HTML, new window).
In response to the COVID-19 pandemic, Arkansas Medicaid is making some lab and primary care procedure codes payable retroactively. These codes will be active in the claims processing system temporarily and should only be performed with an order from the physician.
Pursuant to Executive Order 20-05 and as allowed under current Medicaid policy, DMS is lifting the requirement to have an established professional relationship before utilizing telemedicine for physicians under the following conditions for the duration of the emergency declaration:
- The physician providing telehealth services must have access to a patient’s personal health record maintained by a physician.
- The telemedicine service may be provided by any technology deemed appropriate, including telephone, but it must be provided in real time (cannot be delayed communication).
- Physicians may use telemedicine to diagnose, treat, and, when clinically appropriate, prescribe a non-controlled drug to the patient.
To bill for these services, please use the appropriate billing procedure code with the “GT” modifier and Place of Service (POS) “02.”
Medicaid is also opening the virtual check-in CPT (code G2012) for sixty (60) days. The code will be turned on April 1, 2020 and will be retroactive to date of service March 18, 2020.
DMS is suspending the rule related to originating site requirements for certain behavioral health providers to provide certain counseling services. Any technology deemed appropriate may be used, including telephones, but technology must utilize direct communication that takes place in real-time. Only the following services may be billed:
- Individual Behavioral Health Counseling
- 90832, U4, GT
- 90834, U4, GT
- 90837, U4, GT
- Psychoeducation (H2027, U4, GT)
To learn more, see all COVID-19 related memorandums posted below.
In response to the COVID-19 outbreak in Arkansas and consistent with CMS’s coverage and payment for COVID-19 diagnostic testing, DMS is covering the linked laboratory services (PDF, new window).
As you know, the Governor declared a public health emergency on March 12, 2020, due to the Coronavirus (COVID-19) outbreak in Arkansas. In response to this declaration and the need for social distancing, DMS has issued the following guidance related to certain behavioral health providers using technology for direct communication that takes place in real-time to provide certain counseling services. (PDF, new window).
As you know, the Governor declared a public health emergency on March 12, 2020, due to the Coronavirus (COVID-19) outbreak in Arkansas. In response to this declaration and the need for social distancing, DMS issues the following guidance and policy related to physicians use of telemedicine (PDF, new window).
Arkansas Medicaid released an official notice to all providers regarding 2021 Annual Healthcare Common Procedure Coding System Level II (HCPCS) Code, Current Procedural Terminology (CPT), and ASC Code Conversion. View or print ON-001-21. (Word, new window)
Arkansas Medicaid released a Section V all provider manuals update. View or print the SecV-4-21 transmittal letter. (Word, new window)
View or print changes to Form DMS-7708, Practitioner Identification Number Request Form. (Word, new window)
Arkansas Medicaid released a Section V all provider manuals update. View or print the SecV-3-21 transmittal letter. (Word, new window)
View or print changes to Authorization for Electronic Funds Transfer (Automatic Deposit) form. (Word, new window)
View or print changes to the Application Packet. (Word, new window)
Arkansas Medicaid released a Section V all provider manuals update. View or print the SecV-1-21 transmittal letter. (Word, new window)
View or print changes to Section V. (Word, new window)
View or print contact information for the Appeals Entity. (Word, new window)
View or print contact information for eQHealth Solutions - Arkansas Division. (Word, new window)
Arkansas Medicaid released a Section V all provider manuals update. View or print the SecV-2-21 transmittal letter. (Word, new window)
View or print changes to DMS-7708, Practitioner Identification Number Request Form. (Word, new window)
View or print changes to DMS-652, Division of Medical Services Medical Assistance Program Provider Application. (Word, new window)
View or print changes to the Application Packet. (Word, new window)
Arkansas Medicaid released an RA message to All Providers. View the RA message regarding Faxed EFT Forms Will Not be Accepted Beginning February 15, 2021. (Word, new window)
Arkansas Medicaid released an RA message to All Providers. View the RA message regarding Prior Authorization Letters Location Change. (Word, new window)
Arkansas Medicaid released an RA message to Pharmacy Providers. View the RA message regarding New MAC with Effective Dates of 02/08/2021. (Word, new window)
Arkansas Medicaid released an RA message to ARChoices and Personal Care Providers. View the RA message regarding EVV Billing Deadline. (Word, new window)
Arkansas Medicaid released an RA message to Personal Care Providers. View the RA message regarding Personal Care Services Under Age 21. (Word, new window)