What’s New for Arkansas Medicaid Providers
Content updated August 11, 2020
Effective July 1, 2020, Arkansas Medicaid will pay $15.45 for the administration of an influenza immunization. A rate of $13.14 will be paid for the administration of other Medicaid payable vaccines. The existing rates for Vaccines For Children (VFC) and SCHIP vaccines will be adjusted to account for this rate increase.
For adult vaccines (ages 18 and above), the following HCPCS and CPT codes are to be used in conjunction with the vaccine being administered:
- G0008 – Influenza immunization
- 90471 – First vaccine administered
- 90472 – Subsequent vaccines administered
The Injection administration code, T1502 will continue to be payable for beneficiaries of all ages. T1502 may be used for billing the administration of subcutaneous and/or intramuscular injections only.
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])
There is a new section of the Provider Portal called “Provider Functions”. This new section will be used to submit all Provider Enrollment update requests. Previously, these requests were submitted under “Characteristics”. The panel also allows searching submitted update requests and reviewing the status of each request.
To submit a new update request to Provider Enrollment, navigate to Provider Functions at the top of the page. On the left side of the page, select “Submit an Update Request”. Please ensure you select the appropriate request type for each request. You will then find the file and select “Add”. If you are uploading a document under a group, you will have the option to input the individual provider ID that the document belongs to. Multiple documents can be submitted at once, however, they must be the same request type. The documents are not submitted until you select “Submit” at the bottom right of the page.
Once you submit your document, you can return to Provider Functions and select “Search Update Requests”. Any document that has been submitted in the last 7 days will show in the results panel. In addition, any document with a pending status will remain in the results panel until these status is finalized. You will be able to use the search functions at the top of the page to find previously submitted documents outside of the 7 day period. In the results panel, you will see the status of your update. If you find a status of “Denied” or “Partially Denied” you can click the tracking number to view more details and find the reason for the denial. Once you review the denial reason, correct the issue and re-submit the document.
Prior Authorization letters you received from AFMC dated 7/1/2020 – 7/14/2020 have an incorrect fax number on them. If you are needing to fax
documents to AFMC, please use the following fax number: 479-649-0799. Please resend any documents to the correct fax number if necessary. The
fax number has been corrected for future letters.
DXC Technology’s Medicaid software, Provider Electronic Solutions (PES), which enables health care providers to verify beneficiary eligibility, request prior authorizations, and submit claims electronically will be decommissioned on September 1, 2020. Providers who use PES must transition to using the Arkansas Medicaid HealthCare Provider Portal (or a HIPAA-compliant vendor software) before this date. All PES functionality (including claims submission) will end effective September 1, 2020.
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.
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 Ambulance Services – SPA 2020-0009 and Transportation Provider Manual. View or print the final rule for Ambulance Services. (PDF, new window)
Arkansas Medicaid has released a Final Rule for Medical Services Policy Manual Section E-200. View or print the final rule for Section E-200. (PDF, new window)
Arkansas Medicaid released an official notice to ARKids First-B, Nurse Practitioner, Physician, and Pharmacy Providers regarding Administration Fees for Influenza Immunization and Other Vaccines. View or print ON-006-20. (Word, new window)
Arkansas Medicaid released an official notice to All Providers regarding 3rd Quarter 2020 Healthcare Common Procedure Coding System Level II (HCPCS) Code, Current Procedural Terminology (CPT), and ASC Code Conversion. View or print ON-005-20. (Word, new window)
Arkansas Medicaid released a Transportation provider manual update. View or print the TRANSP-1-20 transmittal letter. (Word, new window)
View or print changes to the Transportation provider manual. (Word, new window)
Arkansas Medicaid released an RA message to Area Health Education Center (AHEC), Arkansas Department of Health, Hospital, Nurse Practitioner, Physician and Rural Health Clinic (RHC) Providers.
View the RA message regarding UPDATE: New COVID-19 Procedure Code 87426 (Coronavirus AG IA). (Word, new window)
Arkansas Medicaid released an RA message to ARChoices and Personal Care Providers Providers.
View the RA message regarding Electronic Visit Verification (EVV) Requirements for Participation. (Word, new window)
Arkansas Medicaid released an RA message to Personal Care, Attendant Care, and Respite Care Providers.
View the RA message regarding AuthentiCare Demonstration. (Word, new window)
Arkansas Medicaid released an RA message to All Providers.
View the RA message regarding Incorrect Fax Number on AFMC Prior Authorization Letters. (Word, new window)