AHCCCS Fee Schedule

Date: 10/28/20

AHCCCS released new fee schedule rates and Differential Adjusted Payment (DAP) guidelines in September. The final changes were made available to us Monday, 10/5/2020.

It is critical that we implement these changes as quickly as we can and just as important that we implement them accurately. Our team is working very hard to complete all of the updates and validate the accuracy of the changes in order to make certain correct rates are applied to claims with dates of service on and after 10/1/20.

As a result, we initially pended all claims for dates of service 10/1/20 and after while we completed this work.

·         The good news is that we began releasing claims last week, i.e. 10/19/20 and as of Monday, 10/26/20 have released 91% of our pended claims for DOS 10/1/20 and after. We are continuing to finalize the remaining changes this week in order to release the rest of the pended claims and will send you a follow up communication when all claims have been released.

·         The bad news is that we confirmed late Monday, 10/19/20 that we mistakenly released 516 claims the week of 10/16/20. We apologize for this mistake. We have identified these claims and will reprocess them as soon as the related fee schedule updates are complete

If you have any questions or concerns on payments for dates of service 10/1/20 and after, please reach out immediately to your Provider Engagement Specialist. Our team will review as a priority and get back to you with an answer as soon as possible