RA messages dated April 30, 2020



Messages for Remittance Advices dated April 30, 2020 – May 7, 2020

|TO: Eligible Professional and eligible hospital Providers |RE: Extended Program Year 2019 Attestation Deadline |

|The attestation deadline for Program Year 2019 has again been EXTENDED until June 30, 2020. Providers who attest by the June deadline will have until July 31, 2020 to finish incomplete applications for |

|the incentive payment. |

|All audit activity for the Promoting Interoperability (formerly known as “EHR") Program has been suspended until May 31, 2020. DMS auditors will contact providers individually who have been selected for |

|audit or with further instruction on how to proceed if audit information has already been submitted. |

|TO: all Providers |RE: Provider Electronic Solutions (PES) Transition |

|DXC Technology’s Medicaid software, Provider Electronic Solutions (PES), enables health care providers to verify beneficiary eligibility, request prior authorizations, and submit claims electronically. |

|PES is being decommissioned, and providers who use PES are strongly encouraged to transition to the Arkansas Medicaid HealthCare Provider Portal before their software becomes obsolete and is no longer |

|supported by DXC Technology. |

|TO: Rural health clinic Providers |RE: RHC – Telemedicine Billing Guidance |

|In response to the COVID-19 outbreak in Arkansas and consistent with CMS guidance, DMS opened the virtual check-in CPT (code G2012). The code was turned on April 23, 2020, with a retroactive effective |

|date of service March 18, 2020. DMS also opened the telemedicine code T1015, U7, GT, with an effective date of April 28, 2020. The telemedicine code is not retroactive. |

|The below billing guidelines are for RHCs billing G2012 and T1015, U7, GT: |

|CMS-1500: Procedure code G2012 or T1015, U7, GT should be submitted with Place of Service 02 |

|UB-04: Procedure code G2012 or T1015, U7, GT must be present on the claim detail in addition to the revenue code being billed. |

|If you have submitted claims on a UB-04 without the code present, please immediately resubmit the claims. |

|To ensure quality and consistency of care to Medicaid beneficiaries, DMS will coordinate with the Office of the Medicaid Inspector General (OMIG) to conduct retrospective reviews of all services provided|

|during this time. Please keep all records of services as required by Medicaid billing rules. |

|TO: Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) Providers |RE: G2012 Requirements for COVID-19 |

|G2012 is being turned on for billing by FQHCs (PT-29) and RHCs (PT-49). The rate is $13.33 per telephonic check-in. The code is for use only with established patients being treated for a chronic |

|condition, including substance use disorder. The code G2012 not part of the all-inclusive rate, and the provider cannot bill an encounter or PPS visit for providing a telephonic check-in. If a |

|face-to-face office service is provided within the defined time frames, then the telehealth visit is bundled with that encounter. It would be considered pre- or post-visit time and not separately |

|billable. |

|TO: Physician, Independent Lab, and OBHS Providers |RE: Temporary Procedure Code Changes in Response to COVID-19 |

|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) |

|Read the full messages and affected codes at . |

|TO: Personal care Providers |RE: revised Personal Care fee schedule |

|The Personal Care fee schedule has been updated to reflect revised rates effective on and after dates of service January 1, 2020. |

If you need this material in an alternative format such as large print, please contact the Office of Rules Promulgation at (501) 320-6266.

Thank you for your participation in the Arkansas Medicaid Program. If you have questions regarding these messages, please contact the Provider Assistance Center at 1-800-457-4454 (toll-free) within Arkansas or locally and out-of-state at (501) 376-2211. Remittance Advices can be found using Search Payment History on the Arkansas Medicaid Provider Portal at .

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