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MedicaidBilling CodesMedium impact

AHCCCS DFSM Claims Clues - August 2019

Arizona Medicaid - AHCCCS·AZ · Psychiatry, Family Medicine, Internal Medicine +1 more·Claims & Billing
Effective date
Jul 1, 2019
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS (Arizona Medicaid) has implemented multiple billing changes including new retroactive coverage rules effective July 1, 2019, adult immunization coverage through county health departments, and system closure of codes H0031 and H2019 for Behavioral Health Residential Facilities effective July 15, 2019.

Action Required

Action needed
Immediately: Behavioral Health Residential Facilities must stop billing H0031 and H2019 codes as these are now closed in the AHCCCS system effective July 15, 2019. Continue using only H0018 per diem code. For adult immunizations (age 19+), verify coverage through county health departments without requiring prior authorization. Update billing processes to account for new retroactive coverage rules starting first day of application month (except pregnant women and children under 19 who retain 3-month retroactive coverage).

Affected Billing Codes

H0031
H2019
H0018