A. There is no benefit limit for acute care/general and rehabilitative hospital inpatient services for beneficiaries under age twenty-one (21) in the Child Health Services (EPSDT) Program. Inpatient services must be approved by the QIO as medically necessary.

B. The benefit limit for acute care/general and rehabilitative hospital inpatient services is twenty-four (24) paid inpatient days per state fiscal year (July 1 through June 30) for Medicaid beneficiaries aged twenty-one (21) and older.

C. When a beneficiary turns twenty-one (21) during an inpatient stay, the dates of service on or after his/her 21^st birthday must be billed separately.

D. Arkansas Medicaid covers up to four (4) days of inpatient services with no certification requirement. If a beneficiary is not discharged before or during the fifth day, additional days are covered only if certified. The Medicaid Utilization Management Program (MUMP) determines covered inpatient lengths of stay in acute care/general and rehabilitative hospitals, in and out of state. See Sections 213.100 and 213.110 for MUMP certification request procedures.

E. Included in the total of paid inpatient days are any days covered by primary third-party resources (except Medicare and Railroad Retirement) for which Medicaid receives a secondary-payer claim that it adjudicates as paid. A Medicaid-secondary claim that adjudicates as a paid claim is counted toward the inpatient benefit limit.

F. Extension of the 24-day inpatient benefit is available under the Medicaid Utilization Management Program (MUMP).