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AHCCCS DFSM Claims Clues - July/August 2020
Effective date
Not stated in the notice
Identified
Jun 17, 2026
Summary
AHCCCS designated the CR modifier for all claims for services provided as a result of, or related to, COVID-19, and providers are asked to begin using it immediately in all appropriate instances. Hospitals may bill long acting reversible contraceptive (LARC) devices separately from the APR-DRG payment on a CMS 1500 claim with the appropriate HCPCS code, reimbursed at the AHCCCS fee schedule rate. Telehealth at the All Inclusive Rate is billed on a UB-04 with revenue codes 0510, 0512 and 0516 and a GT or GQ modifier to indicate telehealth.
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What to do
Action · 10 steps
01Providers: begin using the CR modifier immediately on all claims for services provided as a result of, or related to, COVID-19, in all appropriate instances.
02All other modifier guidance continues to apply.
03Hospitals: bill LARC devices on a CMS 1500 claim form with the appropriate HCPCS code, in addition to procedure code 58300 for IUD insertion, to be reimbursed separately at the AHCCCS fee schedule rate outside the APR-DRG payment.
04Billing team: for IHS and 638 telehealth billed at the AIR on a UB-04, include a GT or GQ modifier on revenue code 0510, 0512 or 0516 to indicate the clinic, dental or urgent clinic visit was done via telehealth.
05Billing team: for telehealth billed at the capped FFS or APM rate on a CMS 1500, list the place of service as the originating site, such as POS 12 (Home) when the member is at home.
06For Medicare Dual members, claims may be submitted with POS 02 (Telemedicine) to comply with Medicare guidelines.
07For members with Medicare as the primary payer, submit the claim to Medicare first and submit the EOB to AHCCCS along with the claim.
08Effective 6/8/20, through the duration of the emergency: the home health or durable medical equipment face-to-face encounter does not need to be completed before services start, but must occur within 12 months from the start of service, and all services are subject to post-payment review.
09For COVID-19 related services other than testing, diagnosis and treatment, the prior authorization document submission period is extended to 90 days.
10Providers who are not registered with AHCCCS but may be the Referring, Ordering, Prescribing or Attending provider must enroll with AHCCCS Previously due January 1, 2021 (date passed; verify current applicability); without that enrollment, an order from an unregistered referring provider is not accepted and the claim from the DME supplier is not paid.
Codes mentioned
58300J7297J7298J7300J7301
Original notice
AHCCCS DFSM Claims Clues - July/August 2020
azahcccs.gov · Always check the source before changing claims.
Related changes
See all Arizona Medicaid - AHCCCS changes →AHCCCS DFSM Claims Clues - October 2020MediumNo effective date · Claims & BillingAHCCCS DFSM Claims Clues - November/December 2020MediumEffective Apr 1, 2021 · Claims & BillingAHCCCS DFSM Claims Clues - September 2016MediumEffective Oct 1, 2016 · Claims & BillingAHCCCS DFSM Claims Clues - March 2020MediumEffective Oct 1, 2016 · Claims & BillingBrowse every Arizona Medicaid - AHCCCS change in the policy list