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Provider Billing Update re: HCPCS H0019 Effective 8/29/2025
Effective date
Aug 29, 2025
Identified
Aug 26, 2026
Summary
Effective August 29, 2025, Ambetter from Arizona Complete Health now requires prior authorization for HCPCS code H0019 (behavioral health; long-term residential per diem). Providers billing this code must obtain prior authorization before submitting claims to avoid denials.
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What to do
Action · 4 steps
01Effective immediately (8/29/2025): Billing team must update billing software and submission workflows to require prior authorization for HCPCS code H0019 for all Ambetter from Arizona Complete Health claims.
02Notify all providers and clinical staff that H0019 claims can no longer be submitted without prior auth.
03Contact Provider Relations Representative if questions arise.
04Claims submitted without prior authorization will be denied.
Codes mentioned
H0019
Original notice
Provider Billing Update re: HCPCS H0019 Effective 8/29/2025
ambetterhealth.com · Always check the source before changing claims.
Related changes
See all Ambetter changes →Ambetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027MediumEffective Jan 1, 2027 · Claims & BillingAmbetter Health of Delaware Billing Code Update for various HCPC H Codes: Effective 01/01/2027HighEffective Jan 1, 2027 · Claims & BillingAmbetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027HighEffective Jan 1, 2027 · Claims & BillingAugust Provider NewsletterHighEffective Jan 1, 2027 · Provider BulletinBrowse every Ambetter change in the policy list