MedicaidBilling CodesHigh impact
AHCCCS DFSM Claims Clues - December 2017
Arizona Medicaid - AHCCCS·AZ · Family Medicine, Internal Medicine, General Practice·Claims & Billing
Effective date
Dec 1, 2017
We identified it
Jun 17, 2026
Summary
AHCCCS introduces new home infusion per diem billing codes S9490 and S9494 (both $58.29) effective 12/1/17, requiring prior authorization and prohibiting separate billing of infusion supplies when per diem codes are used. Primary care providers can now prescribe behavioral health medications for opioid use disorder starting 1/1/18.
Action Required
Immediately: Update billing system to add S9490 and S9494 codes with $58.29 rate and require prior authorization. Set up edits to prevent billing infusion supply codes (A4221, A4222, A4223, A4305, A4306) on same dates as per diem codes. By January 1, 2018: Enable PCP billing for behavioral health medications when treating opioid use disorder with F11.2 diagnosis codes.