MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - October 2022
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Jan 1, 2023
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) has extended the deadline for clinic providers to report individual practitioner NPIs on professional and dental claims until January 1, 2023. Claims will be denied starting that date if the performing practitioner's NPI is not included in field 19 (CMS-1500) or field 35 (ADA forms).
Action Required
By January 1, 2023: Billing team must update claim submission process to include individual practitioner NPIs in field 19 on CMS-1500 forms and field 35 on ADA dental forms for all integrated clinics (Type IC), behavioral health outpatient clinics (Type 77), and general clinics (Type 05). Update billing software and staff training. Claims without practitioner NPIs will be denied with edit code H482.