MedicaidPrior AuthHigh impact
AHCCCS DFSM Claims Clues - December 2018
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Jan 1, 2019
We identified it
Jun 17, 2026
Summary
AHCCCS is retiring the Covered Behavioral Health Services Guide in early 2019, moving information to various manuals and policies. Effective January 1, 2019, all Behavioral Health Residential Facility (BHRF) admissions and continued stays for AIHP and TRBHA members require prior authorization.
Action Required
By January 1, 2019: Billing team must obtain prior authorization for all new BHRF admissions (Provider Type B8) for AIHP and TRBHA members before dates of service 1/1/2019 and later. For members currently receiving services admitted prior to 1/1/19, obtain continued stay authorization by January 31, 2019. Review new policy AMPM 320-V for criteria and check FFS web page for authorization procedures and documentation requirements.