Outpatient Hospital Fee Schedule (OPFS) Technical Information & FAQs

This section contains technical information related to the AHCCCS Outpatient Claim Reimbursement Project.

• Outpatient Hospital Fee Schedule Reference Extracts
  • AHCCCS Specific OPFS CCI Relationships
    • Excel Version
    • PDF Version
• Key Documents
  • Facility Peer Groups (10/01/2024)
  • Facility Peer Groups (07/01/2024)
  • Facility Peer Groups (02/02/2024)
  • Facility Peer Groups
  • OPFS Decision Tree (before 10/1/2011)
  • OPFS Decision Tree (10/1/2011 to 9/30/2020)
  • OPFS Decision Tree (10/1/2020)
• Frequently Asked OPFS Questions

For dates of service on and after 7/1/2005, AHCCCS reimburses in-state, non-IHS hospitals for outpatient services billed on a UB claim form using the AHCCCS Outpatient Hospital Fee Schedule. The Outpatient Hospital Fee Schedule will provide rates at the procedure code level, and Surgery/Emergency Department (ED) services will be bundled similar to Medicare for payment purposes . For more information on outpatient hospital billing requirements, refer to the AHCCCS FFS Provider Manual, Chapters 6 and 11, as well as the information listed as components of this webpage.