Neurology Billing Services in Arkansas

Arkansas's neurology practices face unique billing challenges shaped by Arkansas Blue Cross Blue Shield's commercial rules, Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) requirements, and Novitas Solutions (Jurisdiction H) Medicare policies. Our AAPC-certified coders specialize in both AR payer rules and neurology coding complexity.

AAPC Certified
AR Payer Expert
Neurology Specialists
2.49% Rate
Last reviewed: May 2026Reviewed by the Go Medical Billing Editorial TeamAAPC-certified coders
7,000+AR Physicians
2.49%Starting Rate
4Medicaid MCOs
98%+Clean Claim Rate

Why Arkansas Neurology Practices Need Specialized Billing

Arkansas's healthcare market includes 7,000+ physicians, and neurology practices here face a payer market dominated by Arkansas Blue Cross Blue Shield on the commercial side and Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) on the public payer side. Medicare claims are processed through Novitas Solutions (Jurisdiction H), which applies its own Local Coverage Determinations that directly affect neurology procedure coverage and medical necessity requirements. Generic billing teams without AR specific knowledge leave revenue on the table.

Neurology billing itself is complex. Neurology diagnostic testing codes have professional and technical components, time-based elements, and study-specific documentation requirements. EMG/NCS (95907-95913, 95885-95886) requires documenting specific nerves tested. EEG (95816-95822) has awake, sleep, and long-term monitoring variants. When you combine this coding complexity with Arkansas's specific payer rules, authorization requirements, and 4 Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving neurology practices from Little Rock to Conway and across Arkansas.

2026 Arkansas Medicare Allowables for Neurology CPT Codes

These are the 2026 Medicare allowable amounts for neurology CPT codes in Arkansas, processed under Novitas Solutions (Jurisdiction H). Allowables are locality-adjusted, so ARrates differ from other states — the highest-value neurology code below pays $587.21 non-facility here. Compare any code across states with our Medicare fee calculator by state.

Code
Description
Non-Facility
Facility
Needle EMG, one extremity
$106.57
$106.57
Needle EMG, limited study
$75.66
$75.66
Electroencephalogram (EEG), 20-40 minutes
$359.00
$359.00
Polysomnography with 4 or more parameters
$587.21
$587.21
Established patient office visit, low MDM
$86.86
$54.44
Established patient office visit, moderate MDM
$123.92
$80.02
Established patient office visit, high MDM
$176.04
$118.65

Source: 2026 Medicare Physician Fee Schedule, AR locality (Novitas Solutions (Jurisdiction H)). Commercial Arkansas Blue Cross Blue Shield rates typically run above these benchmarks; Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) rates run below. Figures for reference, not a guarantee of payment.

The Arkansas Market Context for Neurology Practices

Arkansas has about 7,000 physicians and one of the most unusual Medicaid managed care structures in the country. Most Arkansas Medicaid members remain fee-for-service. Only members with intensive behavioral health needs or intellectual and developmental disabilities are in managed care, under the Provider-Led Arkansas Shared Savings Entity (PASSE) program. PASSE entities are at least 51 percent owned by Arkansas Medicaid providers, which makes them provider-led rather than insurance-company-led. The four PASSEs are Arkansas Total Care (Centene), CareSource PASSE, Empower Healthcare Solutions, and Summit Community Care (Anthem). Arkansas expanded Medicaid in 2014 under a private-option model called Arkansas Works, which later became the Arkansas Health and Opportunity for Me (ARHOME) program. The commercial market is dominated by Arkansas Blue Cross Blue Shield statewide. Little Rock is anchored by Baptist Health, CHI St. Vincent (now CommonSpirit), and the University of Arkansas for Medical Sciences (UAMS), which is the state's only academic medical center.

Arkansas-specific factors that shape neurology reimbursement: Arkansas has one of the few Medicaid managed care programs in the country that is provider-led rather than insurance-company-led. PASSEs are majority-owned by Arkansas Medicaid providers.; Most Arkansas Medicaid members remain fee-for-service. Only members with intensive behavioral health or intellectual and developmental disability needs are in PASSE-based managed care.; Arkansas expanded Medicaid in 2014 using a private-option model where eligible adults use Medicaid dollars to buy commercial coverage on the marketplace rather than enrolling in traditional Medicaid.. Our AR coders build these into every neurologyclaim — see how this works alongside our Arkansas medical billing and neurology billing teams.

Arkansas Payer Challenges for Neurology

Every AR payer has specific rules for neurology claims. Here's how we navigate them.

Arkansas Blue Cross Blue Shield Neurology Claims

Arkansas Blue Cross Blue Shield processes the largest share of Arkansas commercial neurology claims. We know their AR specific fee schedules, prior authorization requirements for neurology procedures, and their appeal timelines when claims are denied. Nerve conduction and needle EMG have separate code families that must be coordinated.

Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) Neurology Billing

Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) routes neurology patients through 4 managed care plans: Arkansas Total Care (PASSE, Centene), CareSource PASSE, Empower Healthcare Solutions (PASSE), and 1 more. Each MCO has its own neurology authorization and billing rules that we manage.

Medicare (Novitas Solutions (Jurisdiction H)) Neurology Coverage

Novitas Solutions (Jurisdiction H) processes Medicare neurology claims in Arkansas with its own Local Coverage Determinations. We navigate Novitas Solutions (Jurisdiction H)'s policies around eeg variant selection to prevent medical necessity denials.

Denial Prevention for Arkansas Neurology

Common neurology denials in Arkansas include nerve conduction and needle emg have separate code families that must be coordinated and routine, extended, ambulatory, and video eeg each have different codes and documentation. Our team catches these issues before submission and appeals aggressively with AR payer-specific documentation when denials occur.

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What We Handle for Arkansas Neurology Practices

EEG coding (routine, extended, video, ambulatory)
EMG and nerve conduction study billing
Sleep study billing (PSG and HST)
Neurology infusion therapy coding
Botox injection billing (migraine, spasticity)
Prior auth for advanced neuro testing

Arkansas Neurology Billing Cost Comparison

Hiring an in-house biller with neurology expertise in Arkansas costs $30K-$42K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified neurology coders and AR payer specialists for a fraction of that cost.

$30K-$42K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

Frequently Asked Questions

All major AR payers: Arkansas Blue Cross Blue Shield, QualChoice (now part of Centene), Aetna, UnitedHealthcare, Ambetter, Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) (including Arkansas Total Care (PASSE, Centene), CareSource PASSE, Empower Healthcare Solutions (PASSE)), and Medicare through Novitas Solutions (Jurisdiction H). If a payer accepts neurology patients in Arkansas, we submit and follow-up on claims with them.
The most frequent neurology denials we see from AR payers include nerve conduction and needle emg have separate code families that must be coordinated, routine, extended, ambulatory, and video eeg each have different codes and documentation, neurology infusions (biologics, ivig) require sequential administration coding. Our team catches these before submission by applying both neurology coding expertise and AR payer-specific rules to every claim.
Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD) routes neurology patients through 4 managed care plans: Arkansas Total Care (PASSE, Centene), CareSource PASSE, Empower Healthcare Solutions (PASSE), Summit Community Care (PASSE, Anthem). Each MCO has its own neurology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your neurology practice gets paid correctly.
Most AR neurology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your neurology workflows, and start submitting claims to Arkansas Blue Cross Blue Shield, Arkansas Medicaid (most members fee-for-service, plus PASSE managed care for behavioral health and IDD), Medicare, and all your AR payers with no downtime.

Fix Your Arkansas Neurology Billing

Call 888-701-6090 for a free billing assessment specific to your AR neurology practice. We'll show you where revenue is leaking and how to fix it.