MedicaidReimbursementHigh impact
AHCCCS DFSM Claims Clues - January 2013
Arizona Medicaid - AHCCCS·AZ · Family Medicine, Internal Medicine, Pediatrics·Claims & Billing
Effective date
Jan 1, 2013
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) is implementing enhanced payments for primary care providers equal to Medicare rates for 2013-2014, and introducing a new Agency with Choice member-directed service option with specific billing modifiers. New prior authorization requirements for lodging services also take effect.
Action Required
By March 31, 2013: Qualifying primary care providers (family medicine, internal medicine, pediatrics) must complete AHCCCS attestation forms to receive enhanced Medicare-level payments for E&M and vaccine codes retroactive to January 1, 2013. Update billing system to use modifier U7 for all Agency with Choice services. Implement prior authorization requirements for lodging services (provider types 55 & 56) using mandatory FFS Authorization Request forms.