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Arkansas - Behavioral Health Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

In Arkansas, outpatient behavioral health services—including assessment, therapy, positive behavior support, and crisis response—are certified by the Department of Human Services (DHS) Division of Provider Services and Quality Assurance (DPSQA) as a Behavioral Health Agency (BHA). Services are funded through Arkansas Medicaid and managed primarily by the Provider-Led Arkansas Shared Savings Entity (PASSE) system, which serves individuals with intensive mental health, substance use, or intellectual/developmental disability needs.

To become an approved BHA, an applicant must first obtain national accreditation from an approved body (such as CARF, The Joint Commission, or COA) before they can even apply for state certification. Once accredited, the agency must obtain BHA certification from DPSQA for each specific site, complete Medicaid enrollment through the MMIS Provider Portal, and contract with the PASSE managed care organizations to receive reimbursement for services.

1. Service Definition and Scope

Arkansas Medicaid defines Outpatient Behavioral Health Services as a continuum of care that includes mental health assessments, individual and group therapy, crisis intervention, and positive behavior support. These services are designed to treat symptoms that cause functional deficits and help individuals remain in their homes and communities.

Services are delivered under the Medicaid State Plan and the PASSE 1915(i) State Plan Amendment for behavioral health Home and Community-Based Services (HCBS). Providers must operate as a certified Behavioral Health Agency (BHA) and utilize qualified behavioral health professionals (QBHPs) and licensed clinicians to deliver care.

2. Regulatory and Oversight Agencies

The Arkansas Department of Human Services (DHS) oversees behavioral health services through multiple divisions. The Division of Provider Services and Quality Assurance (DPSQA) handles the licensing and certification of Behavioral Health Agencies.

The Division of Medical Services (DMS) manages Medicaid provider enrollment, while the PASSE organizations act as the managed care entities responsible for care coordination, prior authorizations, and claims payment for the behavioral health population.

3. Gatekeeping Prerequisites: Who Can Even Apply

Arkansas imposes a strict structural prerequisite for Behavioral Health Agencies: mandatory national accreditation. Under 20 CAR § 706-103, an applicant must achieve full accreditation as an outpatient behavioral healthcare provider from CARF, The Joint Commission (TJC), or the Council on Accreditation (COA) before applying for state certification.

Preliminary, provisional, or pending accreditations are explicitly rejected. The initial accreditation must include an on-site survey for every service site for which the provider is requesting state certification. Without this full, site-specific national accreditation, DPSQA will not accept a BHA certification application.

4. Licensure and Certification Requirements

Once accredited, the provider must apply for Behavioral Health Agency (BHA) certification through DPSQA. Certification is site-specific; while an applicant can submit one application for multiple sites, DPSQA reviews and certifies each site separately.

Providers must use DHS Behavioral Health Agency Form 250 to apply for new sites. The agency must prominently display its accreditation certificate at each site and operate under the exact business name registered with the Arkansas Secretary of State.

5. Medicaid Provider Enrollment

After obtaining BHA certification, providers must enroll in Arkansas Medicaid via the MMIS Health Care Provider Portal. Initial applications must be submitted electronically. The name on every document—including the application, W-9, and BHA certification—must match exactly, as name mismatches are the top reason for denial in Arkansas.

Behavioral health agencies are subject to Moderate Categorical Risk Screening under 42 CFR §455.432, which includes unannounced pre-enrollment or post-enrollment site visits by DMS or its agents. Providers must also select which PASSEs they wish their application data routed to during the portal process.

6. Staffing, Training and Background Checks

Arkansas requires strict background checks for behavioral health staff. Providers must submit the DCO-92 form (Arkansas Criminal History Record Check Request for Medicaid Provider Enrollment) for agency staff. This is a state-specific requirement, and failure to complete it results in immediate application denial.

Agencies must utilize licensed healthcare professionals and Qualified Behavioral Health Providers (QBHPs). Providers must notify the Office of Medicaid Inspector General (OMIG) of the names of all covered healthcare practitioners providing services, updating this list by the tenth day of each month for new staff.

7. Documentation, Policies and Records

BHAs must maintain comprehensive records, including Person-Centered Service Plans (PCSPs) developed in coordination with PASSE care coordinators. Providers must verify member eligibility and prior authorizations before delivering care.

Arkansas has specific rules for agency closure or site transition. If a site closes, the provider must use DHS Behavioral Health Agency Form 220, provide actual notice to clients, post a public notice at the site entry listing alternative BHAs within a 50-mile radius, and submit a transition plan to DHS.

8. Billing, Rates and Claims

Providers bill for outpatient behavioral health services through the PASSEs for enrolled members, or through the Medicaid MMIS for fee-for-service populations. Claims must be submitted electronically using correct billing codes according to PASSE guidelines.

All Arkansas Medicaid claims must be submitted within 365 days of the date of service. Providers must set up Electronic Funds Transfer (EFT) by attaching a voided check or signed bank letter in the portal; deposit slips are not accepted.

9. Approval Sequence and Timeline

The approval sequence begins with obtaining full national accreditation, which can take several months to a year. Once accredited, the provider submits Form 250 to DPSQA for BHA certification.

After certification is issued, the provider submits the Medicaid enrollment application via the MMIS portal, including the DCO-92 background check forms. The Moderate Risk unannounced site visit adds 14 to 45 days to the standard enrollment timeline. Finally, the provider must execute contracts with the PASSEs.

10. Common Denials and Survey Findings

The most frequent cause of Medicaid enrollment denial in Arkansas is a name mismatch. The business name on the W-9, application, BHA certification, and licensing board records must match exactly.

Other common reasons for denial or delay include missing the DCO-92 background check form, submitting outdated enrollment forms, failing to forward license/certification renewals within 30 days of issuance, and failing the unannounced site visit because the location is not operating as a working clinic.

11. Key Contacts and Resources

Providers should utilize the DHS portals and division websites for the most current forms and manuals. The Provider Enrollment unit handles MMIS applications, while DPSQA manages BHA certification.

For PASSE contracting, providers must contact the individual managed care organizations directly. The DHS HCBS and PASSE provider pages offer detailed fact sheets and policy updates.

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