MedicaidPrior AuthMedium impact
Prior Authorization Required for J2789
Arkansas Medicaid·AR · Ophthalmology·Prior Authorization
Effective date
Oct 13, 2026
We identified it
Oct 15, 2026
Summary
Effective October 13, 2026, Arkansas Medicaid now requires prior authorization for J2789 (Riboflavin 5'-phosphate ophthalmic solution) and procedure code 0402T (corneal collagen cross-linking). Providers must submit separate PA requests for each code through the Arkansas Foundation for Medical Care; approval of one does not constitute approval of the other.
Action Required
Effective October 13, 2026: Billing team must implement prior authorization workflow for Arkansas Medicaid claims involving J2789 and 0402T. Specific actions: (1) Update billing system to flag claims containing J2789 or 0402T for mandatory PA submission before processing; (2) Establish dual PA submission process—submit J2789 under PA Process Type 112 (Other Medical Service) and 0402T under PA Process Type 136 (Surgical Procedures) to Arkansas Foundation for Medical Care; (3) Train billing staff that approval of 0402T does NOT automatically approve J2789—separate approvals required; (4) For outpatient hospital claims billing both codes, verify charges for J2789 are included in 0402T charges per Arkansas Medicaid Hospital Provider Manual Section 272.160, as separate reimbursement may be denied. Submit PAs electronically via Medicaid Provider Portal (https://portal.mmis.arkansas.gov/armedicaid/provider/Home/tabid/135/Default.aspx) or contact Arkansas Foundation for Medical Care at 1-800-426-2234 (toll-free). Claims without approved prior authorization will be denied for Medicaid reimbursement.