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AHCCCS DFSM Claims Clues - December 2023

Arizona Medicaid - AHCCCS·AZ · Psychiatry, Dentistry·Claims & Billing
Effective date
Dec 1, 2023
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS (Arizona Medicaid) has updated multiple billing requirements including mandatory use of Place of Service code 56 for Behavioral Health Residential Facilities effective December 1, 2023, new denial codes for missing behavioral health documentation, and requirement for new 2024 ADA dental claim forms starting January 1, 2024.

Action Required

Action needed
Immediately: Update billing system for BHRF Provider Type B8 to use Place of Service code 56 for HCPCS H0018 claims with dates of service December 1, 2023 and after. By January 1, 2024: Switch to new ADA 2024 dental claim forms - stop accepting ADA 2012 forms. Billing team must ensure all behavioral health documentation includes member's full name, DOB, and AHCCCS ID on every page, and obtain required member signatures on consent forms. Claims missing proper documentation will be denied with specific codes AD364, AD075, AD963, AD964, AD965, AD966.

Affected Billing Codes

H2016
H0038
H0018