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AHCCCS DFSM Claims Clues - March 2013
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) requires all claims to list the correct rendering provider who actually provided the care. Billing with another provider's ID number is prohibited except in approved locum tenens situations, and hospitals/clinics cannot bill using facility NPI numbers for physician/mid-level practitioner services.
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What to do
immediately · 4 steps
01Billing team must ensure all AHCCCS claims list the actual rendering provider who provided care.
02Stop billing with substitute provider ID numbers except for approved locum tenens arrangements.
03Physicians and mid-level practitioners must use their individual NPI numbers, not facility NPI numbers.
04Review current billing practices to identify violations as audits may result in claim denials, recoupments, or penalties.
Codes mentioned
T2038
Original notice
AHCCCS DFSM Claims Clues - March 2013
azahcccs.gov · Always check the source before changing claims.
Related changes
See all Arizona Medicaid - AHCCCS changes →AHCCCS DFSM Claims Clues - September 2026MediumNo effective date · Claims & BillingAHCCCS DFSM Claims Clues - August 2026HighEffective Aug 24, 2026 · Claims & BillingAHCCCS DFSM Claims Clues - July 2026HighEffective Jul 20, 2026 · Claims & BillingAHCCCS DFSM Claims Clues - January 2013HighEffective Jan 1, 2013 · Claims & BillingBrowse every Arizona Medicaid - AHCCCS change in the policy list