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Arkansas medicaid dms 640 form

016 05 18 Ark Code R 003 - Summary of the Occupational 2025

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The document outlines the procedures for prescribing and referring occupational, physical, and speech therapy services for Medicaid-eligible beneficiaries under the age of 21 in Arkansas. It details the requirements for primary care physicians to complete a referral form (DMS-640) for therapy evaluation and prescription, including necessary patient information, diagnosis, and therapy specifics. The document also emphasizes the need for regular renewal of referrals and provides financial data on therapy expenditures.

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