MedicaidReimbursementMedium impact
AHCCCS Releases Billing Guidance for Differential Adjusted Payment
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Oct 1, 2024
We identified it
Jun 17, 2026
Summary
AHCCCS has released updated billing guidance for Differential Adjusted Payment (DAP) programs, which provide positive payment adjustments to Fee-for-Service rates for providers who commit to specific care improvement actions. Providers must include the DAP increase value when billing directly to AHCCCS or MCOs to receive the enhanced reimbursement.
Action Required
For CYE 2025 (October 1, 2024 - September 30, 2025): Billing team must verify if practice is on the qualifying provider lists for applicable specialties and ensure DAP adjustment values are included when billing AHCCCS or MCOs for services. Review the qualifying provider lists by specialty type and contact AHCCCSDAP@azahcccs.gov with reimbursement rate questions.