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AHCCCS DFSM Claims Clues - January 2017

Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Jan 1, 2017
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS (Arizona Medicaid) has implemented new prior authorization requirements for behavioral health non-emergency medical transport (NEMT) over 100 miles for TRBHA members, effective January 1, 2017. The policy also limits phone authorizations to pending hospital discharges only and requires providers to use online portals for most authorization requests.

Action Required

Action needed
Immediately: For Arizona providers serving TRBHA members (Gila River, Pascua Yaqui, Navajo Nation, White Mountain Apache), obtain prior authorization for all behavioral health NEMT trips over 100 miles. Submit requests online at https://azweb.statemedicaid.us with valid BH diagnosis codes (use F99 if unknown). Stop calling FFS PA staff for member eligibility or authorization status - use online portal instead. Only call 602-417-4400 for pending hospital discharge authorizations.

Affected Billing Codes

F99