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Arkansas - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

Arkansas funds non-medical supervision and socialization through the ARChoices in Homecare 1915(c) waiver under the umbrella category of Attendant Care Services, which encompasses companion, personal care, and homemaker tasks. To bill for companion services (procedure code 08040), an entity must first obtain licensure from the Arkansas Department of Health as either a Private Care Agency or a Class A/Class B Home Health Agency before submitting a Medicaid enrollment application.

The Division of Medical Services (DMS) and the Division of Provider Services and Quality Assurance (DPSQA) oversee the Medicaid enrollment and waiver certification processes. Applicants must secure their state license, obtain a National Provider Identifier (NPI), and implement an approved Electronic Visit Verification (EVV) system to be approved as an ARChoices waiver provider.

1. Service Definition and Scope

In Arkansas, standalone "Adult Companion Services" are not enrolled as a distinct provider type; instead, they are covered as a component of Attendant Care Services under the ARChoices in Homecare waiver. This service provides non-medical supervision, socialization, and assistance with daily living activities to allow adults to remain safely in the community.

The scope of tasks and the maximum allowable hours are strictly determined by state nurses during the participant's assessment, meaning providers cannot independently determine the frequency or duration of companion care.

2. Regulatory and Oversight Agencies

Multiple divisions within the Arkansas Department of Human Services (DHS) and the Arkansas Department of Health (ADH) share oversight of Attendant Care and companion providers. ADH handles the foundational facility and agency licensure, while DHS manages waiver operations, quality assurance, and Medicaid provider agreements.

The state utilizes an independent contractor to manage the Medicaid Management Information System (MMIS) and process provider enrollment applications.

3. Gatekeeping Prerequisites: Who Can Even Apply

Arkansas does not restrict Attendant Care/companion provider enrollment through a Certificate of Need (CON) for Private Care Agencies, nor does it use closed network procurements (RFPs) for this specific waiver service. However, an applicant cannot submit a Medicaid enrollment application for the ARChoices waiver without first holding an active state license.

Because companion services are billed under the Attendant Care umbrella, the agency must also be enrolled as an Arkansas Medicaid Personal Care Provider. There are currently no moratoria blocking new Private Care Agency applications.

4. Licensure and Certification Requirements

To provide companion services under the Attendant Care umbrella, the agency must meet ADH licensure standards for a Private Care Agency (or Home Health Agency). This involves submitting a licensure application, passing a state survey, and demonstrating compliance with operational and administrative rules.

Once licensed, the agency must maintain continuous compliance. Failure to renew the license annually and report it to Medicaid will result in termination of the provider agreement.

5. Medicaid Provider Enrollment

After obtaining the required ADH license, agencies must apply through the Arkansas Medicaid Provider Portal. The enrollment process requires paying an application fee, undergoing federally mandated screening, and signing the Arkansas Medicaid Provider Contract.

Providers must revalidate their enrollment at least every five years to maintain active billing status.

6. Staffing, Training and Background Checks

Agencies must ensure all direct care workers providing companion services meet state-defined competency and background check requirements. Providers are strictly obligated to screen all employees against federal and state exclusion databases.

Every rendering caregiver must be registered with the state to obtain a unique identification number for EVV tracking.

7. Documentation, Policies and Records

Arkansas mandates strict documentation for all HCBS waiver services, particularly regarding time and attendance. Providers must implement an Electronic Visit Verification (EVV) system to record the delivery of companion and attendant care services.

Telemedicine and remote supervision are explicitly excluded for this service; caregivers must be physically present with the participant.

8. Billing, Rates and Claims

Companion services are billed using specific procedure codes under the Attendant Care Services category. Reimbursement is managed through the MMIS portal based on a statewide rate methodology established by DMS.

Providers cannot bill for hours that exceed the prior authorized limits set by the state's Task and Hour Standards.

9. Approval Sequence and Timeline

The critical path to becoming a billing provider starts with state licensure, followed by Medicaid enrollment and EVV implementation. The entire process typically takes several months depending on ADH survey schedules and DMS screening times.

Agencies cannot accept waiver referrals or begin billing until the Medicaid Provider Contract is fully executed.

10. Common Denials and Survey Findings

Applications and active enrollments are frequently delayed or revoked due to administrative omissions or failure to maintain continuous licensure. DPSQA and the Medicaid fiscal agent actively monitor license status.

EVV discrepancies are a primary cause of claim denials for established providers.

11. Key Contacts and Resources

Providers should rely on the official Arkansas DHS and ADH portals for the most current manuals, forms, and policy updates. The MMIS portal is the central hub for enrollment and billing inquiries.

The state's provider manuals are updated regularly and serve as the binding policy for all waiver services.

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