MedicaidDocumentationMedium impact
AHCCCS DFSM Claims Clues - May 2025 - Special Release
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
May 2, 2025
We identified it
Jun 17, 2026
Summary
AHCCCS has issued new documentation and prior authorization requirements for behavioral health services under Fee-for-Service management. Providers must ensure complete documentation meets clinical standards and respond promptly to requests for additional information to avoid claim denials.
Action Required
Immediately: Behavioral health providers must review and comply with AHCCCS documentation standards for all prior authorization requests. Access the AHCCCS Medical Policy Manual sections 310-B, 820, 320-V, and 940, plus the Covered Behavioral Health Services Guide. Ensure all treatment plans are contemporaneously documented with individualized member needs, ongoing assessments, and treatment responses. Contact ServiceDesk@azahcccs.gov for training assistance and CareManagers@azahcccs.gov for member-related matters. Incomplete documentation will result in requests for additional information and potential claim delays.