MedicaidPrior AuthMedium impact
AHCCCS DFSM Claims Clues - FFS Behavioral Health NEMT Updates and Reminders
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Jun 15, 2017
We identified it
Jun 17, 2026
Summary
AHCCCS Fee-for-Service now requires prior authorization for behavioral health non-emergency medical transport (NEMT) services for members enrolled with specific Tribal Regional Behavioral Health Authorities. A new BT event type must be used for behavioral health NEMT authorization requests effective June 15, 2017.
Action Required
By June 15, 2017: Billing team must update authorization system to use new BT event type for behavioral health NEMT requests (replacing OR, RR, or OT event types). Ensure all behavioral health NEMT authorization requests include valid BH diagnosis codes, are submitted prior to service delivery, specify transport reason, and are for trips over 100 miles. Use F99 diagnosis code when BH diagnosis is unknown at time of request.