January 14, 2022

Arizona: New RHC/FQHC school billing guidelines effective Jan. 1, 2022

Starting Jan. 1, 2022, the Arizona Health Care Cost Containment System (AHCCCS) requires the place of service of the member for all services. The AHCCCS updated their Fee-for-Service Provider Billing Manual Chapter 10 Addendum for billing school place of service. Health care professionals using the CMS-1500 claim form (includes those using digital billing) should follow these new guidelines or the state may deny claims.

These updated billing requirements include medical and dental services:

  • List the Rural Health Clinic (RHC)/Federally Qualified Health Center (FQHC) as the rendering provider
  • List the 0B qualifier (indicates a state license) followed by:

To report 1 participating health care professional

screenshot showing the information used when submitting a claim with 1 participating provider.

To report 2 participating health care professionals

screenshot showing the information used when submitting a claim with 2 participating providers.
PCA-1-21-04631-C&S-News_01032022