MedicaidBilling CodesMedium impact
AHCCCS DFSM Claims Clues - July/August 2020
Arizona Medicaid - AHCCCS·AZ · OB-GYN, Family Medicine, Internal Medicine·Claims & Billing
We identified it
Jun 17, 2026
Summary
AHCCCS has implemented new billing requirements including mandatory use of CR modifier for all COVID-19 related services, separate reimbursement for LARC devices outside APR-DRG payments, and expanded telehealth billing guidance for IHS/638 providers with specific 'Four Walls' provisions.
Action Required
Immediately: Billing team must add CR modifier to all claims for services provided as a result of or related to COVID-19. Update billing system to allow separate reimbursement for LARC devices (codes J7297, J7298, J7300, J7301) on CMS 1500 forms outside of APR-DRG payments. Train staff on IHS/638 telehealth billing requirements including proper use of UB-04 vs CMS 1500 forms based on All Inclusive Rate vs Capped FFS Rate billing.