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016.06.54-202.100. Billing Providers of RSYC Services for Youth in the Custody or Care of Arkan...

AR ADC 016.06.54-202.100Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 54. Rehabilitative Services for Youth and Children (Rsyc) Provider Manual
Section 202.000. Arkansas Medicaid Participation Requirements for Rsyc.
Ark. Admin. Code 016.06.54-202.100
016.06.54-202.100. Billing Providers of RSYC Services for Youth in the Custody or Care of Arkansas Division of Youth Services (DYS).
Currentness
Billing providers (DYS) of Rehabilitative Services for Youth under 21 years of age must meet the following criteria in order to be eligible for participation in the Arkansas Medicaid Program:
A. Rehabilitative Services for Youth billing providers must complete a provider application (Form DMS-652), a Medicaid contract (Form DMS-653) and a Request for Taxpayer Identification Number and Certification (Form W-9) with the Arkansas Medicaid Program. (View or print a provider application (Form DMS-652), Medicaid contract (Form DMS-653) and Request for Taxpayer Identification Number and Certification (Form W-9).
B. The provider application and the Medicaid contract must both be approved by the Arkansas Medicaid Program.

Credits

Eff. Oct. 13, 2003.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.54-202.100, AR ADC 016.06.54-202.100
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