Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 05 - Developmental Disabilities Services › Rule 016.05.22-001 - Occupational Therapy, Physical Therapy, and Speech-Language Pathology State Plan Amendment

Current through Register Vol. 49, No. 6, June, 2024
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
				MEDICAL ASSISTANCE PROGRAM STATE ARKANSAS METHODS AND STANDARDS FOR
				ESTABLISHING PAYMENT RATES
-
OTHER TYPES OF CARE
ATTACHMENT 4.19-B
4.
b. Early
			 and Periodic Screening and Diagnosis of Individuals Under 21 Years of Age and
			 Treatment of Conditions Found (Continued)
(19)
Physical Therapy, Occupational Therapy, and Speech-Language Therapy
			 Services
Effective for dates of service on or after October
1
, 1999, the Arkansas Medicaid maximum rates for physical therapy
				services, occupational therapy services and speech
-
language
				therapy services are based on court-ordered rates issued by the United States
				District Court, Eastern District of Arkansas, Western Division and agreed upon
				by the Division of Medical Services and representatives of the Arkansas
				Physical Therapy Association, the Arkansas Occupational Therapy Association and
				the Arkansas Speech-Language-Hearing Association.
Effective April 9, 2022, t
he agency's fee schedule
				rates
for occupational therapy, physical therapy, and speech-language
				pathology treatment services
were set
based on an average of 2019
				Medicare utilization data for the same services
.
The fee schedule
				rates for occupational therapy, physical therapy, and speech-language pathology
				evaluations were determined to be in line with Medicare and were not changed.
				The occupational therapy, physical therapy, and speech-language pathology
				treatment rate adjustments will be implemented over two (2) years. An initial
				rate increase of sixteen percent (16%) will be implemented on April 9, 2022,
				and the second increase of fifteen percent (15%) will be implemented on April
				1, 2023.
The applicable
fee schedule
of
rates
at any given time
are published on the agency's website (Fee
				Schedules - Arkansas Department of Human Services). A uniform rate for these
				services is paid to all governmental and non- governmental providers unless
				otherwise indicated in the state plan. The State assures that physical
				therapists, occupational therapists and Speech-Language therapists will meet
				the requirements contained in
				42
				CFR 440.110.
Therapy Assistants - Effective for dates of service on or after
				October I, 1999, the Arkansas Medicaid maximum for the physical therapy
				assistant, occupational therapy assistant and the speech
-
language
				therapy assistant is based on 80% of the amount reimbursed to the licensed
				therapist.
Fee schedule service reimbursement is based on the lesser of
				the amount billed or the Arkansas Title XIX (Medicaid) maximum charge
				allowed.
1.
Physical
			 Therapy
Listed below are covered physical therapy services:
Description
Evaluation for physical therapy
Individual physical therapy Group
physical therapy
Individual physical therapy by physical therapy assistant
				Group
physical therapy by physical therapy assistant
At the beginning of each calendar year, Medicaid officials and
				the Arkansas Physical Therapy Association or its successor will arrive at
				mutually agreeable increase or decrease in reimbursement rates based on the
				market forces as they impact on access. Any agreed upon increase or decrease
				will be implemented at the beginning of the following state fiscal year, July 1
				with any appropriate State Plan changes.