Implementation of CG.CC.PP.01 General Lab CG.CP.MP.01-07 Infectious Disease Testing

Date: 08/26/25

New Requirements for General Lab and Infectious Disease Testing and Screening Services

Effective October 1, 2025, Arizona Complete Health is implementing payment policy CG.CC.PP.01 and clinical policies CG.CP.MP.01-CG.CP.MP.07 for Medicaid (Arizona Complete Health-Complete Care Plan), Marketplace (Ambetter from Arizona Complete Health), and Medicare (Wellcare by Allwell (HMO) and Wellcare (PPO)) lines of business.

Payment policy CG.CC.PP.01 addresses correct coding for general lab services.

Clinical policies CG.CP.MP.01-CG.CP.MP.07 outline medical necessity requirements for the following infectious disease testing and screening services:

1.     CG.CP.MP.01: Respiratory

2.     CG.CP.MP.02: Multisystem

3.     CG.CP.MP.03: Dermatologic

4.     CG.CP.MP.04: Gastroenterologic

5.     CG.CP.MP.05: Primary Care & Preventative

6.     CG.CP.MP.06: Vector-borne and tropical disease

7.     CG.CP.MP.07: Genitourinary

The policies are available on our website www.azcompletehealth.com > For Providers > Provider Resources > Clinical & Payment Policies and on our Marketplace website www.ambetterhealth.com > click on AZ in state map > For Providers > Clinical and Payment Policies

If you have questions, please contact your Provider Engagement Account Manager. If you need your assigned Provider Engagement Account Manager’s contact information, please email us: AzCHProviderEngagement@azcompletehealth.com.