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AHCCCS DFSM Claims Clues - June 2023

Arizona Medicaid - AHCCCS·AZ · Behavioral Health, Primary Care, Family Medicine·Claims & Billing
Effective date
May 12, 2023
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS has discontinued COVID-19 related billing modifiers and codes effective May 12, 2023. The CR modifier and DR condition code can no longer be used, and specific COVID-19 specimen collection codes (G2023, G2024, U0003-U0005) are now denied. New Community Health Worker codes are available with strict unit limits.

Action Required

Action needed
Immediately: Remove CR modifier and DR condition code from all claims dated May 12, 2023 and after. Stop billing COVID-19 specimen collection codes G2023, G2024, U0003, U0004, U0005 as they will be denied. For Community Health Worker services, implement unit limits of maximum 4 units per day and 60 units per 30 days for codes 98960-98962. For behavioral health services exceeding 8 units per day, attach comprehensive assessment, treatment plan, and medical records via Transaction Insight Portal.

Affected Billing Codes

G2023
G2024
U0003
U0004
U0005
98960
98961
98962
H2033
H0004
H0038
H2011
H2014
H2015
H2017
H0025
H2027
S5150
T1016
T1019
H0034