Summit Community Care is one of the four PASSEs DHS lists. Its prior-authorization list (updated February 11, 2026) includes the ABA codes, and its July 2026 provider manual sets the decision clock and claims rules. Summit publishes no ABA clinical policy of its own, so the Arkansas Medicaid ABA manual supplies eligibility, forms, supervision and telehealth rules for its members.
Summit’s PA list names 97151, 97152, 97153, 97154, 97155, 97156 and 97158 for Arkansas Medicaid. Only four ABA codes are payable under the state fee schedule (97151, 97153, 97155, 97156), and the state does not reimburse group codes 97154 and 97158, so plan around those four. Summit’s manual decides standard requests within two business days of receiving all necessary information, “not to exceed 7 calendar days from the date of the request,” and urgent ones within one business day, not to exceed 72 hours. With no Summit ABA policy published, the state ABA manual governs eligibility (EPSDT, ages 18 months to 21), the DMS-641 ER and TP forms, BCBA supervision and documentation.[1][2][6][8][5]
Summit’s manual repeats Section I: a provider treating Arkansas patients by telehealth “shall be fully licensed or certified to practice in Arkansas,” and the distant-site provider must be enrolled in Arkansas Medicaid. Virtual services may be delivered in the member’s home or a community setting with documented consent; audio-only, fax, text and email are not reportable encounters. For ABA specifically, the state manual allows only 97155 and 97156 by telemedicine. Paper and electronic claims must be filed within 365 calendar days of the date of service, and secondary claims within 180 days of the primary payer’s payment date.[2][5][9]
The questions that decide whether a family can start with Summit Community Care, and what they have to bring. Each maps onto something intake should ask on the first call.
Summit publishes no ABA age rule, so the state rule applies: EPSDT enrollees “between eighteen (18) months and twenty-one (21) years of age.”[2][5]
No diagnosis expiry; the state manual’s BCBA reevaluation runs every 6 months (ages 18 months to 8) or 12 months (8 to 21).[2][5]
Summit publishes nothing different, so the state rule applies: a DMS-641 ER evaluation referral and a DMS-641 TP treatment prescription from the member’s assigned PCP. Under the state manual the treatment prescription is valid for up to six months for a child aged 18 months to 8 and up to 12 months for ages 8 to 21, unless the prescriber sets a shorter period, and both DMS-641 forms are posted by DHS.[2][5][11][12]
Summit requires telehealth providers to be “fully licensed or certified to practice in Arkansas” and enrolled in Arkansas Medicaid, and allows virtual care in the home with documented consent. For ABA the state rule applies: only 97155 and 97156 by synchronous telemedicine; all other ABA in person.[2][5]
Standard: within two business days of receiving all necessary information, “not to exceed 7 calendar days from the date of the request.” Urgent: within one business day, not to exceed 72 hours.[2]
Secondary and tertiary claims “must be submitted within 180 days from the payment date from Medicare or the third-party payer.” Under the PASSE manual, the PASSE handles coordination of benefits as Medicaid’s delegate and pays a previously denied claim if the primary later refused it for timely filing or missing prior authorization because the member did not disclose the other coverage (90 days to resubmit).[2][3]
Not stated by Summit. Under the state rule, qualified professionals under Ark. Code Ann. § 20-77-124 diagnose (Acentra’s fee-for-service list: licensed psychologist, licensed physician or SLP, with MD or DO confirmation).[2][8]
Ask the plan: Summit Community Care Utilization Management via Provider Services, 844-462-0022.
Coverage decides whether Summit Community Care pays. These decide whether the claim survives: how sessions must be staffed and supervised, what may be billed concurrently, the per-day ceilings, who signs the note, where the service is payable, and whose NPI the claim goes out under.
Summit publishes no ABA supervision rule of its own, so the state rule applies. The state manual sets the floor. A BCaBA or RBT must be supervised by an Arkansas Medicaid-enrolled BCBA, who must directly observe in person at least “Five percent (5%) of the total ABA therapy treatment hours performed by the BCaBA or RBT” and at least “One (1) hour of ABA therapy treatment delivery performed by BCaBA or RBT every thirty (30) days.” Between observations the BCBA must be “on-call and immediately available” (telecommunication is enough), must review and approve the technician’s data and progress notes before any claim is submitted, and is capped at the lesser of “twelve (12) BCaBAs and RBTs at any given time” or a caseload needing no more than 25 billable hours of 97155 a week. RBTs must hold BACB certification; a trainee may be treated as an RBT for up to six months.[2][5]
Summit publishes no ABA unit limit, so the state rule applies: weekly units may not exceed the authorization, missed units do not carry forward, and one clinician may bill no more than 50 hours of ABA treatment a week.[2][5]
Summit publishes no ABA note rule, so the state rule applies: names, credentials and signatures of the staff on each session note, weekly BCBA-signed progress notes, and BCBA approval of technician notes before the claim.[2][5]
Summit’s manual allows virtual services in the member’s home or a community setting with documented consent. It sets no ABA-specific setting rule; the state manual requires the plan of care to justify the setting and limits ABA telemedicine to 97155 and 97156.[2][5]
Not addressed by Summit. The state manual bars concurrent billing “unless otherwise specifically provided for” and does not say in words whether 97153 and 97155 may share minutes.[2][5]
Ask the plan: Summit Community Care Provider Services, 844-462-0022.
Summit publishes no ABA rendering-provider rule. The state manual requires a group to name the certified practitioner as the performing provider and every individual, RBTs included, to enroll with Arkansas Medicaid.[2][5]
Ask the plan: Summit Community Care Provider Services, 844-462-0022: ask whose NPI goes in the rendering field for RBT-delivered 97153.
Yes, for PASSE members under the Arkansas Medicaid ABA manual (EPSDT, ages 18 months to 21), with prior authorization on the ABA codes.
Within two business days of receiving all necessary information, and never more than seven calendar days from the request; urgent requests within one business day, no more than 72 hours.
Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed October 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member.
Carelu collects all of this automatically.
Every ID, document, and detail this payer requires — gathered conversationally the moment a family reaches out, with insurance verified before your team touches the file.
Get a Demo