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AHCCCS DFSM Claims Clues - Billing Clarification: Behavioral Health Per Diem Service Codes

Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Feb 6, 2024
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS clarifies that behavioral health per diem services for American Indian Health Program members cannot be billed with multiple per diem codes on the same day. The per diem rate is a bundled payment covering all routine behavioral health services for that day.

Action Required

Action needed
Immediately: Billing team must update system edits to prevent multiple behavioral health per diem service codes from being billed on the same date for AHCCCS American Indian Health Program members. Review current claims for potential duplicate billing and implement daily bundling rules in billing software.