AHCCCS News & Updates 
March 30, 2022

Participating Provider Information Requirement Effective June 1, 2022


As of June 1, 2022, AHCCCS providers must begin to report the individual practitioner who rendered services on professional and dental service claims. This requirement impacts all claims for AHCCCS providers registered as integrated clinics (Provider Type IC), behavioral health outpatient clinics (Provider Type 77) and clinics (Provider Type 05).

Claims for dates of service on and after June 1, 2022 will be denied by AHCCCS and its Managed Care Organizations if the individual practitioner who performed the services associated with the clinic visit is not reported. See Exhibit 10-1 of the AHCCCS Fee-For-Service Provider Billing Manual for billing instructions for proper claims’ submissions.

Questions can be directed to David Rudnick at david.rudnick@azahcccs.gov.

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