CurrentCareSourcePolicy N/A

Credentialing of Opioid Use Disorder (OUD) Providers — Arkansas PASSE

Defines credentialing, training, and conditions of coverage for providers delivering medication for opioid use disorder (MOUD) within the Arkansas PASSE program; affects prescribers, opioid treatment programs (OTPs), and participating/non-participating providers in Arkansas.

Policy Summary

PayerCareSource

PolicyCredentialing of Opioid Use Disorder (OUD) Providers — Arkansas PASSE

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateMar 1, 2026

Next Review DateN/A

Key ActionRegistered practitioners must complete a one-time 8-hour training on treatment and management of patients with opioid or other substance use disorders.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

8 hoursone-time training

RequiredDEA registration

RequiredOTP accreditation

Prior authPrior auth for non-participants

ArkansasJurisdiction

Credentialing and Coverage Criteria

Providers must meet training, licensure, certification, and program-level requirements to be credentialed and to deliver covered services; non‑participating providers require prior authorization.

Providers must comply with current federal and state regulations.

Training requirement: Registered practitioners must complete a one-time 8-hour training on the treatment and management of patients with opioid or other substance use disorders (SUDs).

Training exemptions (satisfies 8-hour requirement if any apply)

Board certification in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, American Board of Addiction Medicine, or the American Osteopathic Association.

Policy Summary

PayerCareSource

PolicyCredentialing of Opioid Use Disorder (OUD) Providers — Arkansas PASSE

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateMar 1, 2026

Next Review DateN/A

Key ActionRegistered practitioners must complete a one-time 8-hour training on treatment and management of patients with opioid or other substance use disorders.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Addiction Medicine prescriber requirements (one of the following for MD/DO; APRN alternative)

Unrestricted Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) license PLUS one of: certification by the American Board of Addiction Medicine; subspecialty certification in addiction medicine by the American Board of Preventive Medicine; subspecialty certification in addiction psychiatry by the American Board of Psychiatry and Neurology; certificate of added qualification in addiction medicine from the American Osteopathic Association; OR completion of an accredited residency/fellowship in addiction medicine or addiction psychiatry.
Unrestricted licensed Advanced Practice Registered Nurses (APRNs) who completed the Nurse Practitioner Substance Use Disorder Medical Education Project (NP-SUDMedEd) training.

Buprenorphine prescriber requirements

For MD/DO: unrestricted MD or DO license AND registration with the DEA to dispense Schedule III, IV, and V medications for treatment of pain.
For other practitioners (Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist, Certified Nurse Midwife, Physician Assistant): unrestricted license AND all of the following: practice in an office-based setting; DEA registration to dispense Schedule III–V medications for pain treatment; training or experience demonstrating ability to treat and manage opioid‑dependent members; and supervision by or employment in collaboration with a qualifying physician when applicable and as required by state licensure.

Provider Actions and Prior Authorization

Prior Authorization

Prior Authorization for Non-participating Providers

Non-participating providers (those who are not contracted with CareSource) must obtain prior authorization before rendering services to CareSource members. Failure to secure prior authorization may result in claim denial or reduced reimbursement. Prior authorization requests should include all required clinical documentation and be submitted through CareSource's designated prior authorization portal or by the method specified in provider communications.

Applies to any provider not participating in CareSource network
Prior authorization must be obtained before the date of service except in defined emergency situations
Include supporting clinical documentation with the authorization request
Submit requests via CareSource prior authorization portal or as instructed in provider materials
Lack of prior authorization may lead to denial of payment or member balance billing restrictions

Key Definitions

Opioid Treatment Program (OTP)

DefinitionOpioid Treatment Program (OTP): Program/qualified practitioner accredited and certified by SAMHSA, delivering opioid treatment with an opioid agonist medication.

Accreditation/certificationOTP must be accredited and certified by SAMHSA as stated in the definitions.

Role in medication deliveryOTPs deliver opioid treatment using opioid agonist medications (e.g., methadone) in accordance with federal and state regulations.

Opioid Use Disorder (OUD)

DSM-5-TR criteriaOpioid Use Disorder (OUD): presence of at least 2 of 11 clinical criteria from the DSM-5-TR within a 12-month period.

Severity rangeSeverity ranges from mild to severe based on the number and intensity of criteria met.

Includes tolerance/withdrawalDiagnostic criteria include manifestations such as tolerance and withdrawal when applicable.

OpenPayer

Credentialing of Opioid Use Disorder (OUD) Providers — Arkansas PASSE

Credentialing and Coverage Criteria

Coding and Billing Notes

Provider Actions and Prior Authorization

Key Definitions