Help Desks / Support Centers

(800) 457-4454
in-state toll-free or
(501) 376-2211
local and out-of-state

Arkansas Payment Improvement Initiative
(866) 322-4696 in-state toll-free or
(501) 301-8311 local and out-of-state

Magellan Medicaid Administration Pharmacy Help Desk
(800) 424-7895, Option 2 for Prescribers

What’s New for Arkansas Medicaid Providers

Smiling dental provider

Content updated September 18, 2020

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Medication Assisted Treatment for Opioid Use Disorder

Added 9/16/20
Effective September 1, 2020, Arkansas Medicaid will support beneficiaries with Opioid Use Disorder (OUD). The program allows Medication Assisted Treatment (MAT) patients to exceed the 12 physician visits per year limit, and the $500 benefit limit for laboratory and x-ray services when associated with MAT. Beneficiaries will not be charged a co-pay for covered MAT services, and the medications provided will not count toward the beneficiaries’ prescription limit.

To provide MAT services, current Medicaid providers must submit a written letter requesting their XDEA be added to their provider file, a copy of their DEA certificate, and a copy of the XDEA approval letter from SAMHSA. The MAT designation is for billing purposes; documentation should be uploaded on the HealthCare Provider Portal to qualify. (For help, see the MMIS Job Aid to learn how to upload documents (PDF, new window) on the portal.)

To enroll as a new Arkansas Medicaid provider offering MAT services, learn how to submit your enrollment application online. Upload your DEA certificate and SAMHSA approval letter as attachments to your application to ensure your XDEA is entered on your provider file.

Affiliated Provider Listing Available in the Provider Portal

Added 9/1/20
You are now able to find a listing of all providers affiliated with your group in the Provider Portal. To access this list, log into the Provider Portal and select Characteristics on the left side of the page. There is a new tab under Characteristics called “Provider Affiliates”. Click the “+” to expand the list.

All active affiliations will display in the list. A provider is considered active if they have at least one current contract. If all contracts are closed, the provider is considered inactive. For inactive affiliations, only those within the last three years will be listed. We determine the three year period by comparing the affiliation end date to the current date.

Suspension of NICU Retrospective Reviews

Added 8/27/20
Effective August 10, 2020, the Neonatal Intensive Care Unit (NICU) retrospective reviews have been suspended per DMS until further notice. All reviews not received and completed prior to August 10, 2020 will not be completed.

UPDATE: New COVID-19 Procedure Code 87426 (Coronavirus AG IA)

Added 8/3/20
Effective on August 7, 2020, the following procedures codes are available for billing COVID-19 antigen detection testing. These codes will be retroactive to dates of service June 25, 2020, and forward.

Procedure Code: 87426
Short Description: Coronavirus AG IA
Long Description: Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
Fee: $45.23

Electronic Visit Verification (EVV) Requirements for Participation

Updated 6/15/20
For Personal Care Providers along with AR Choices: Attendant Care and Respite Providers: Section 12006(a) of the 21st Century Cures Act (HTML, new window) mandates that states implement Electronic Visit Verification (EVV) for all Medicaid personal care services (PCS) that require an in-home visit by a provider. These services include Personal Care, Attendant Care, and Respite provided under the Medicaid State Plan and under Home and Community Based Services waivers to individuals in the home.

In order for Agency or self directed providers to participate in EVV by January 1, 2021, all personal care, attendant care and respite aides will need to enroll in Arkansas Medicaid by applying for a practitioner ID number (PIN). These aides will not be billing providers, only listed on the claim as the rendering provider for Identification purposes. The Personal Care, Attendant Care and Respite Aides should submit their applications via the Provider Portal (HTML, new window) beginning April 29, 2020. When completing an application, the enrollment type is atypical, provider type is 95 — registered, non-credentialed provider and the specialty code is NT — registered, non-credentialed. Additionally, there will be a question asking if the application is for a personal care aide, which should be indicated as ‘yes,’ even if you are providing attendant care or respite. When completing whether online or paper; the aides personal email address will be needed. This will allow the aide to reset password without calling the help desk.

While paper applications (Word, new window) 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.

Personal Care, Attendant Care and Respite Aides need to be enrolled no later than September 30, 2020. If you are a Provider that is required to be part of EVV, there is not an opt-out option.

For questions regarding the enrollment process, please contact DXC Technology Provider Enrollment at 1-800-457-4454, locally at 501-376-2211. Thank you in advance for your cooperation and compliance.

Important Information From DHS About the COVID-19 Public Health Emergency

Added 4/8/20
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).

Temporary Procedure Code Changes in Response to COVID-19

Added 3/20/20
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.

Laboratory Testing for COVID-19

Updated 8/4/20
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).

Telemedicine Requirements for Certain Behavioral Health Providers During the COVID-19 Public Health Emergency

Added 3/19/20
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).

Telemedicine Requirements for Physicians during the COVID-19 Public Health Emergency

Added 3/18/20
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).

New Final Rules

Added 9/18/20
Arkansas Medicaid has released a Final Rule for State Plan #20-0002, Episode-1-19, and SecI-3-19 all provider manuals update. View or print the final rule for State Plan 20-0002. (PDF, new window)

Added 8/21/20
Arkansas Medicaid has released a Final Rule for Medication Assisted Treatment (MAT). View or print the final rule for MAT. (PDF, new window)

New Provider Manual Updates

Added 9/18/20
Arkansas Medicaid released an Episodes of Care provider manual update. View or print the EPISODE-1-19 transmittal letter. (Word, new window)
View or print changes to the Episodes of Care provider manual. (Word, new window)

Arkansas Medicaid released a Section I all provider manuals update. View or print the SecI-3-19 transmittal letter. (Word, new window)
View or print changes to Section I all provider manuals (3-19). (Word, new window)

Added 8/21/20
Arkansas Medicaid released a Federally Qualified Health Center (FQHC) provider manual update. View or print the FQHC-1-19 transmittal letter. (Word, new window)
View or print changes to the FQHC provider manual. (Word, new window)

Arkansas Medicaid released a Hospital provider manual update. View or print the HOSPITAL-5-19 transmittal letter. (Word, new window)
View or print changes to the Hospital provider manual. (Word, new window)

Arkansas Medicaid released a Nurse Practitioner provider manual update. View or print the NURSEPRA-3-19 transmittal letter. (Word, new window)
View or print changes to the Nurse Practitioner provider manual. (Word, new window)

Arkansas Medicaid released an Outpatient Behavioral Health Services (OBHS) provider manual update. View or print the OBHS-1-19 transmittal letter. (Word, new window)
View or print changes to the OBHS provider manual. (Word, new window)

Arkansas Medicaid released a Pharmacy provider manual update. View or print the PHARMACY-2-19 transmittal letter. (Word, new window)
View or print changes to the Pharmacy provider manual. (Word, new window)

Arkansas Medicaid released a Physician provider manual update. View or print the PHYSICN-4-19 transmittal letter. (Word, new window)
View or print changes to the Physician provider manual. (Word, new window)

Arkansas Medicaid released a Rural Health Clinic provider manual update. View or print the RURLHLTH-1-19 transmittal letter. (Word, new window)
View or print changes to the Rural Health Clinic provider manual. (Word, new window)

Arkansas Medicaid released a Section I all provider manuals update. View or print the SecI-4-19 transmittal letter. (Word, new window)
View or print changes to Section I all provider manuals (4-19). (Word, new window)

New RA Messages

Added 9/17/20
Arkansas Medicaid released an RA message to Hospice Providers. View the RA message regarding Hospice Payment Rates. (Word, new window)

Arkansas Medicaid released an RA message to ARChoices and Personal Care Providers. View the RA message regarding Electronic Visit Verification (EVV) AuthentiCare System Demonstration on Portal. (Word, new window)

Added 9/1/20
Arkansas Medicaid released an RA message to Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) Providers. View the RA message regarding Replacement Billable Code for Telemedicine Encounters. (Word, new window)

Arkansas Medicaid released an RA message to Hospital Providers. View the RA message regarding NICU Reviews. (Word, new window)