Quick Billing Reminder
If you bill for Arizona Medicaid, AHCCCS, members, there’s an important rule to know: Incident to Billing is not allowed. Let’s break down what that means and how to stay compliant.
What’s the Rule?
AZ Blue Health Choice follows AHCCCS guidelines. The key rules are:
- Each provider must use their own NPI (National Provider Identifier)
- Physicians and mid-level practitioners must be registered with AHCCCS
- You cannot use “incident-to” for billing services under a different provider (like a physician) when someone else performed the care.
- This includes services from Advanced Practice Providers (APPs)
Who Does This Apply To?
These rules apply to many provider types, including (but not limited to):
- Doctor of Medicine (MD)
- Doctor of Osteopathic Medicine (DO)
- Physician Assistants • Registered Nurse Practitioners
- Clinical Nurse Specialists
- Certified Nurse Midwives
- Certified Registered Nurse Anesthetists (CRNAs)
- Surgical First Assistants
- Affiliated Practice Dental Hygienists
Learn More
This guidance comes from many sources. Learn more from: