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AHCCCS DFSM Claims Clues - May 2023 - Transaction Insight Portal for Outpatient Behavioral Health Providers

Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
May 9, 2023
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS now requires providers to submit comprehensive assessment, treatment plan, and medical records when billing more than 8 units of specific behavioral health codes in one day. Documentation must be attached using the Transaction Insight Portal (TIBCO) system.

Action Required

Action needed
Immediately: Behavioral health billing staff must request Transaction Insight Portal accounts by emailing servicedesk@azahccccs.gov with organization name, Provider ID, full name, and work email. When billing more than 8 units of any listed BH codes per day, attach comprehensive assessment, treatment plan, and medical records using TIBCO portal with Set Purpose Code 11 for existing claims or Set Purpose Code 02 for new claims through AHCCCS portal.

Affected Billing Codes

H0004
H0038
H2011
H2014
H2015
H2017
H0025
H2027
S5150
T1016
T1019
H0034