What’s New for Arkansas Medicaid Providers
Content updated November 23, 2020
Effective 11/30/2020, the procedure code 97530, which has been used by First Connection providers to bill Developmental Therapy and Developmental Therapy Assistant services, will be end-dated. Starting 12/01/2020 and after, First Connections providers must use the new procedure codes listed below to bill Developmental Therapy and Developmental Therapy Assistant services.
- T1027: Individual Therapeutic Therapy by a Developmental Therapist
- T1027 UB: Individual Therapeutic Therapy by a Developmental Therapist Assistant
This change only applies to First Connections providers under Part C of the Individuals with Disabilities Education Act.
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 Gainwell Technologies Provider Enrollment at 1-800-457-4454, locally at 501-376-2211. Thank you in advance for your cooperation and compliance.
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 has released a Final Rule for State Plan Amendment 2020-0017, Hyperalimentation, and Prosthetics provider manual updates. View or print Final Rule SPA20-0017, HYPER-1-19, and PROSTHET-3-19. (PDF, new window)
Arkansas Medicaid has released a Final Rule for Electronic Visit Verification (EVV) Implementation. View or print Final Rule for EVV. (PDF, new window)
Arkansas Medicaid has released the Final Rule for State Plan #2019-0009, TRANSP-1-19, and SecV-2-19 all provider manuals update. View or print the final Rule #98. (PDF, new window)
Arkansas Medicaid released an official notice to all providers regarding 4th Quarter 2020 Healthcare Common Procedure Coding System Level II (HCPCS) Code, Current Procedural Terminology (CPT), and ASC Code Conversion. View or print ON-008-20. (Word, new window)
Arkansas Medicaid released a Section I all provider manuals update. View or print the SecI-1-19 transmittal letter. (Word, new window)
View or print changes to Section I all provider manuals. (Word, new window)
Arkansas Medicaid released a Section V all provider manuals update. View or print the SecV-4-19 transmittal letter. (Word, new window)
View or print changes to Section V all provider manuals. (Word, new window)
View or print EVV Vendor Information. (Word, new window)
Arkansas Medicaid released an RA message to All Providers.
View the RA message regarding Crossover Claim Edit Changes and Reprocessing. (Word, new window)
Arkansas Medicaid released an RA message to Pharmacy Providers.
View the RA message regarding New MACs with Effective Dates of 12/15/2020. (Word, new window)
Arkansas Medicaid released an RA message to Developmental Rehabilitation Services (Early Intervention Only) Providers.
View the RA message regarding Early Intervention / First Connection Providers. (Word, new window)