Therapeutic Communities Authorization Requests

Date: 01/03/24

Beginning February 1, 2024, providers that offer Therapeutic Communities under the 1915(i) State Plan for Home- and Community-Based Services (HCBS) will need to make sure the reviews are only submitted for Prior Authorization via the Outpatient Treatment Review (OTR) form. In addition, the following change will need to occur:

If you are requesting Therapeutic Communities Level 1, please place the UC modifier on the OTR. If you are requesting Therapeutic Communities Level 2, please leave the modifier box blank. This will assist our Utilization Management team in distinguishing between the two levels. Please do not change the way the service is billed. This is for Prior Authorization requests only.

Level 1 example:

Level 2 example:

To find the clinical policy criteria for all 1915(i) services, please visit our Provider Resources page.

Thank you for your continued partnership in helping Arkansas live better. If you have any questions or concerns, please contact us at 1-866-282-6280 (TTY: 711).