MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - March 2022
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Jun 1, 2022
We identified it
Jun 17, 2026
Summary
AHCCCS updated provider participation agreements and introduced new provider reporting requirements effective June 1, 2022, for specific clinic types. Claims must now include participating provider information in designated fields or face denial with edit code H482.
Action Required
By June 1, 2022: Billing team must update claim submission processes to include participating provider NPI information in Field 19 (CMS 1500) or Field 35 (ADA forms) for provider types 05 (Clinic), 77 (Outpatient Behavioral Health Clinic), and IC (Integrated Clinic). Update billing software to prevent claims submission without this information to avoid denial edit code H482. Review and accept new provider participation agreements within 30 days of publishing.