BHUM Medicaid Prior Authorization Changes, effective 4/15/2025

Date: 02/18/25

Medicaid Behavioral Health Prior Authorization Changes

Effective 4/15/25

Arizona Complete Health-Complete Care Plan requires prior authorization (PA) as a condition of payment for designated services. It is the ordering, prescribing, or referring provider’s responsibility to use our Pre-Auth Check Tools to verify if a specific code requires PA.

To confirm if a CPT/HCPCS code requires PA, please use the Pre-Auth Check Tool on our website www.arizonacompletehealth.com > For Providers > Pre-Auth Check.

Non-participating providers and facilities require PA for all services, unless the Pre-Auth Check Tool indicates otherwise.

Please verify eligibility and benefits prior to rendering service. Regardless of PA, payment is contingent upon the member’s eligibility on the date of service and the service being a covered benefit.       

The PA requirement change for the services outlined below is effective 4/15/25:

Service Category	Service	Procedure Code	PA Rule
Behavioral Health	Skills Training and Development, per 15 minutes	H2014	PA required if more than 8 units/day provided to any member
	Psychosocial Rehabilitation, per 15 minutes	H2017	PA required if more than 8 units/day provided to any member

  

If you have questions, please contact your AzCH Provider Engagement Specialist. To obtain the contact information of you assigned AzCH Provider Engagement Specialist, please email us at AzCHProviderEngagement@azcompletehealth.com.