MedicaidBilling CodesHigh impact
AHCCCS DFSM Claims Clues - April 2014
Arizona Medicaid - AHCCCS·AZ · Emergency Medicine·Claims & Billing
Effective date
May 1, 2014
We identified it
Jun 17, 2026
Summary
AHCCCS has updated outpatient hospital billing restrictions, clarifying that emergency room, observation, and outpatient services provided before inpatient admission must be included in the inpatient tiered per diem payment rather than billed separately. Additionally, new Independent Provider (Type 24) registrations will end May 1, 2014, with the program being phased out by end of 2014.
Action Required
By May 1, 2014: Stop accepting new Independent Provider (Type 24) applications and direct prospective providers to Direct Care Service Agencies. Immediately: Update UB04 billing procedures to ensure dates of service encompass all services related to inpatient stays, including emergency room, observation, and outpatient services provided before admission. Do not bill these services separately as they are included in the inpatient tiered per diem payment. Claims with mismatched service dates will be denied as billing errors.