MedicaidPrior AuthMedium impact
AHCCCS DFSM Claims Clues - September 2024
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Oct 1, 2024
We identified it
Jun 17, 2026
Summary
AHCCCS FFS has updated prior authorization requirements effective October 1, 2024, requiring separate PA submissions when services span different rate periods. Key changes include new process for behavioral health residential facilities and clarification that FES members don't need PA for inpatient hospital services except outpatient dialysis.
Action Required
By October 1, 2024: Billing team must update PA submission process to create separate prior authorization requests when services span different AHCCCS FFS rate periods (October 1 - September 30). For behavioral health residential facilities (B8), submit one PA for current rate period ending 9/30/2024 and a separate PA for new rate period starting 10/1/2024. Stop submitting PAs for FES members' inpatient hospital services except outpatient dialysis. Update PA workflow to ensure Activity Tab completion with CPT/HCPCS codes and date spans.