Arkansas Medicaid Provider Agreement

The remote vendor must use the GT modifier and duty station 02 for billing for CPT or HCPCS codes. CPT codes requiring prior authorization from the AFMC are available in your Arkansas Medicaid Provider manual. (section 241.000, page II-77.) These manuals as well as manual updates are distributed by Medicaid to all Arkansas Medicaid providers. Authorization for procedures, in-house surgeons or length of stay indicates that the AFMC has identified the medical necessity. This does not mean that the patient is entitled to Medicaid coverage. The provider is responsible for verifying the patient`s suitability for performance data. Virtual services may include an interdisciplinary care team or be provided by individual clinical service providers. The following information is required to enable afmc to conduct a verification of the medical necessity of a prior authorization procedure: the skilled person or unit located at the remote site must be an authorized Arkansas Medicaid supplier. It is recommended that providers benefit from telemedicine services when personal treatment is not easily accessible.

Arkansas Medicaid requires that certain surgical procedures be authorized prior to AFMC surgery. Procedures may be subject to fears of authorization, whether inpatient or outpatient. To request permission, call AFMC at 800-426-2234 between 8:30.m-12 p.m. and 1-5 p.m. Monday to Friday, except holidays. See “Procedure for Obtaining Prior Authorization” in the Arkansas Medicaid Provider Manual, Section 241.000, page II-77. AFMC Pre-Certification Number: 800-426-2234AFMC Telephone evaluation hours: 8:30 am.m-12 pm.m and from 1 to 5 am .m Monday to Friday, except holidays. All calls are monitored for quality assurance purposes….