MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - December 2022
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Jan 1, 2023
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) has multiple policy updates for December 2022 including elimination of $1000 dental limits at IHS/638 facilities for AI/AN members, new diabetes self-management training coverage, and mandatory individual practitioner reporting for clinic claims starting January 1, 2023.
Action Required
By January 1, 2023: Billing team must update all professional and dental service claims for integrated clinics (Provider Type IC), behavioral health outpatient clinics (Provider Type 77), and clinics (Provider Type 05) to include individual practitioner modifier identifying who rendered services. Update billing system to require this field. Claims will be denied after January 1, 2023 if individual practitioner is not reported. Also update EVV billing procedures as hard claim edits begin January 1, 2023 - claims without complete EVV visit data will not be paid.