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AHCCCS DFSM Claims Clues - October 2014

Arizona Medicaid - AHCCCS·AZ · Family Medicine, Internal Medicine, General Practice +2 more·Claims & Billing
Effective date
Jan 1, 2015
We identified it
Jun 17, 2026
Days to comply

Summary

Starting January 1, 2015, AHCCCS will change how FQHCs and RHCs are paid, moving from fee-for-service with annual reconciliation to paying the all-inclusive per visit PPS rate on each claim. All FQHC and RHC visits must use specific new G-codes for medical visits and D-codes for dental visits, with all other services bundled into the visit at $0 value.

Action Required

Action needed
By January 1, 2015: FQHC and RHC billing teams must update billing systems to use new G-codes (G0466-G0470) for all medical/behavioral health visits on Form 1500 and D-codes (D0120, D0140, D0145, D0150, D0180) for dental visits on ADA forms. Configure systems to bundle all other services at $0 value with the visit code. Update encounter forms and train staff on new visit identification requirements. Also respond immediately to any A+ Government Solutions requests for PERM audit documentation from October-December 2013 claims to avoid fund recovery.

Affected Billing Codes

G0466
G0467
G0468
G0469
G0470
D0120
D0140
D0145
D0150
D0180