MedicaidPrior AuthMedium impact
Eating Disorder Services – No PCP Referral Required
Arkansas Medicaid·AR · Psychiatry, Internal Medicine, Family Medicine +1 more·Provider Notice
Effective date
Jan 7, 2026
We identified it
Jan 7, 2026
Summary
Arkansas has eliminated the requirement for patients to obtain a Primary Care Physician (PCP) referral before accessing eating disorder services. This streamlines access to specialized eating disorder treatment by allowing direct referrals and self-referrals. Billing teams must update authorization workflows to reflect that PCP referrals are no longer a prerequisite for these services.
Action Required
By January 7, 2026: Billing and authorization teams must update prior authorization procedures and billing system logic to remove PCP referral requirements for eating disorder services. Remove any system rules that block or delay claims for eating disorder treatment pending PCP referral documentation. Update internal authorization checklists and communicate to front desk and clinical staff that patients may access eating disorder providers directly without PCP authorization. Inform providers serving eating disorder patients of the policy change. Failure to update procedures may result in unnecessary claim denials or processing delays.