MedicaidCoverageMedium impact
AHCCCS DFSM Claims Clues - November 2015
Arizona Medicaid - AHCCCS·AZ · Endocrinology, Cardiology, Palliative Care·Claims & Billing
Effective date
Jan 1, 2016
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) has updated several policies including new coverage for continuous glucose monitoring and home infusion therapy (both effective 10/1/15), upcoming hospice rate changes with new payment tiers effective 1/1/2016, and clarifications on transportation limitations and prior authorization processes.
Action Required
By January 1, 2016: Billing team must update hospice billing procedures to accommodate new two-tier payment structure (days 1-60 vs 61+) and implement new G-codes for RN versus LPN visits. Update system to track hospice service days across all care levels to determine proper payment tier. Begin using online web portal (https://azweb.statemedicaid.us) for prior authorization submissions instead of phone calls. For CGM and home infusion services, ensure prior authorization is obtained before providing services that became covered 10/1/15.