Updates to the Mental Health Services and Addiction and Recovery Treatment Services (ARTS) Manuals

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Memo

October 2, 2026, 12:17PM

To:

Providers of Mental Health and ARTS Services, Acentra Health, and Cardinal Care Managed Care Organizations

From:

Steve Ford, Director Department of Medical Assistance Services (DMAS)

The purpose of this memorandum is to notify providers of updates to the Mental Health Services and Addiction and Recovery Treatment Services (ARTS) Manuals.

Re-entry Targeted Case Management Supplement

The Re-entry Targeted Case Management (RTCM) Supplement is being added to the Mental Health Services and Addiction and Recovery Treatment Services (ARTS) Manuals. The RTCM supplement describes provider and service requirements for RTCM, a new targeted case management service implemented on July 1, 2026 in accordance with Item 288.GGGG of the 2025 Appropriation Act. RTCM is designed to assist eligible individuals involved in the carceral system transition to the community by coordinating needed medical, behavioral health, social, educational, and other services during the period immediately prior to and following release.

Mental Health Services Manual Chapter IV

The Comprehensive Needs Assessment section of Chapter IV to the Mental Health Services Manual has been updated to allow the option of a Comprehensive Needs Assessment for RTCM.

Mental Health Services Manual Chapter II

References to RTCM have been added. In addition, outdated language specific to providers of Mental Health Services has been removed. No changes have been made to the participating provider requirements in this Chapter.

To avoid disruption to claims payment through FFS and the MCOs providers must periodically check the DMAS provider portal, also known as the Provider Services Solution (PRSS), to ensure that the provider's enrollment, contact information, and license information is up to date, for all of the provider's respective service locations. Under federal rules, MCOs and DMAS are prohibited from paying claims to network providers who are not enrolled in PRSS. Additional information is provided on the MCO Provider Network Resources webpage and includes links to resources, tutorials and contact information to reach Gainwell with any provider enrollment or revalidation related questions. Dental providers should continue to enroll directly through the DMAS Dental Benefits Administrator, DentaQuest.

PROVIDER CONTACT INFORMATION & RESOURCES

Virginia Medicaid Web Portal Automated Response System (ARS)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

https://vamedicaid.dmas.virginia.gov/

Medicall (Audio Response System)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

1-800-884-9730 or 1-800-772-9996

Provider Appeals

Effective November 5, 2026, providers must use the online appeal portal to file appeals and track the status of appeals. Visit the website listed for appeal resources and to register for the portal

https://www.dmas.virginia.gov/appeals/

Managed Care Programs

Cardinal Care Managed Care and Program of All-Inclusive Care for the Elderly (PACE). In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals.

Cardinal Care Managed Care

https://www.dmas.virginia.gov/for-providers/managed-care/cardinal-care-…

PACE

Program of All-inclusive Care (virginia.gov)

Provider Enrollment

In-State: 804-270-5105

Out of State Toll Free: 888-829-5373

Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com

Provider HELPLINE

Monday–Friday 8:00 a.m.-5:00 p.m. For provider use only, have Medicaid Provider ID Number available.

1-804-786-6273

1-800-552-8627