MedicaidPrior AuthMedium impact
Other Medical Service PA Process Type Now Available for Carved-Out Drugs and Services
Arkansas Medicaid·AR · Wound Care, Orthopedics, Allergy & Immunology +4 more·Provider Notice
Effective date
Feb 25, 2026
We identified it
Mar 2, 2026
Summary
Arkansas Medicaid has expanded prior authorization (PA) process options for carved-out drugs and services effective February 25, 2026. Providers must now submit certain medications and services (skin substitutes, radiopharmaceuticals, knee injections, and allergy injections) using new PA process types in the Medicaid Provider Portal instead of previous pathways. Additionally, providers can now submit reconsideration requests for previously denied PAD PAs through the Provider Portal.
Action Required
By February 25, 2026: Billing team must update internal PA submission workflows to route the following services to new Medicaid Provider Portal process types: (1) Skin substitutes/wound care (Q4186 and similar) to Other Medical Service PA Process Type (PT 112); (2) Knee injections (J7318-J7332) to Viscosupplementation PA Process Type (PT 113); (3) Radiopharmaceuticals (A9513, A9595, A9607) to Other Medical Service PA Process Type (PT 112); (4) Allergy injections to Professional Services PA Process Type (PT 126). Providers must cease submitting these items through previous carved-out processes. Continue submitting transplant medications (J2562) and sickle cell gene therapies (J3394, J3392, J3389) directly to Utilization Review per existing protocol. Train all billing staff on the new portal submission process and process type codes. Update claim submission software and encounter forms to reflect new routing requirements. Verify staff can access the Provider Portal at https://portal.mmis.arkansas.gov/armedicaid/provider/Home/tabid/135/Default.aspx. Communicate changes to all ordering providers. Failure to use correct PA process types will result in claim denials.