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MedicaidDocumentationMedium impact

AHCCCS DFSM Claims Clues - March 2014

Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Apr 1, 2014
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS corrected billing rules for the -TN modifier (not billable for Phoenix/Tucson NEMT trips), reinforced that medical records must be submitted with -59 modifier claims and cannot be double-sided, and requires NEMT providers to obtain Tribal business licenses and display company signage effective April 1, 2014.

Action Required

Action needed
By April 1, 2014: NEMT providers must obtain Tribal business license from applicable Tribes and submit copy to AHCCCS Provider Registration. Display company name/logo on all transport vehicles. Billing team must ensure medical records submitted with -59 modifier claims are single-sided only and include appropriate documentation. Claims with -59 modifier will trigger medical review.

Affected Billing Codes

99201
99499
77261
77499