August 18, 2022

Arizona Medicaid: AHCCCS prior authorization and utilization guidelines

At the beginning of the COVID-19 pandemic, the federal government enacted a national public health emergency (NPHE) for community health enrollees. The NPHE established that everyone enrolled in government-assistance programs will maintain their eligibility through the end of the pandemic surge. The NPHE has been extended in Arizona.

What this means for you
In response to the NPHE, the Arizona Health Care Cost Containment System (AHCCCS) made changes to its prior authorization and utilization guidelines on Aug. 1, 2022. The changes apply to the following services and will take effect on Oct. 1, 2022:

  • Behavioral health
  • Dental
  • Physical health

Go to AHCCCS to see how these changes may affect your practice.

Please verify member eligibility before each visit to your practice. You may refer members who no longer have health care coverage to the Health Care Marketplace at or 800-318-2596, TTY  855-889-4325.

Contact your Provider Advocate.