MedicaidBilling CodesMedium impact
2026 Quarter 3 Healthcare Common Procedure Coding System Level II (HCPCS) Code and Current Procedural Terminology (CPT) Code Conversion
Arkansas Medicaid·AR · Oncology, Hematology, Infectious Disease +4 more·Coding
Effective date
Jul 1, 2026
We identified it
Aug 7, 2026
Summary
Arkansas Medicaid is implementing Q3 2026 HCPCS and CPT code updates effective 7/1/2026. New injectable drug procedure codes become payable (including biosimilars, immunoglobulins, and oncology agents), while one terminated code (C9309) becomes non-payable after 6/30/2026. Providers must update billing systems, obtain prior authorizations where required, and resubmit claims with terminated codes for mass adjustment by the state.
Action Required
By 6/30/2026: Billing team must identify and halt billing of terminated code C9309 (INJ ONASE ABEPAR-BRVE TREAT). By 7/1/2026: Update billing system to recognize all new payable HCPCS codes (A9574, C9310, J0528, J1289, J1577, J2361, J3405, J9053, J9062, J9232, Q5164-Q5170) by provider type (Hospital, Nurse Practitioner, Physician), age restrictions, and diagnosis groups. Configure system to require prior authorization for codes marked with "Y" in PA column: J0528, J1289, J1577 (age 18-20 only), J2361, J3405, J9053, J9062, J9232, Q5164-Q5170. For codes J1577 and J9062 requiring modifier U1 for ages 18-20, update system to append modifier automatically. Providers must submit all claims with terminated code C9309 prior to the 365-day filing deadline; Arkansas DHS will perform mass adjustment to recoup paid claims. Ensure all new code submissions include NDC billing protocol unless code is radiopharmaceutical, vaccine, or allergen immunotherapy. Training: Brief clinical staff on new code requirements and age/diagnosis-based restrictions. Contact Provider Assistance Center at (800) 457-4454 if clarification needed on specific codes.