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AHCCCS DFSM Claims Clues - July 2023
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
May 3, 2023
We identified it
Jun 17, 2026
Summary
AHCCCS Arizona Medicaid has implemented multiple billing changes effective May 2023, including new documentation requirements for behavioral health claims, elimination of audio-only telehealth modifier FQ for evaluation and management codes, and restrictions on providers billing on behalf of others.
Action Required
Immediately: For behavioral health providers (B8, IC, 77) - submit comprehensive assessment, treatment plan, and medical records with all outpatient behavioral health claims. Stop using modifier FQ for evaluation and management codes after July 1, 2023 - use modifier GT for telehealth services with audio/video only. Update billing system to prevent same-day billing of H2016 and H0038 codes. Verify affiliated provider lists in AHCCCS Online system before billing on behalf of other providers. Claims without proper documentation or using incorrect modifiers will be denied.