Place of Service Update for Behavioral Health Residential Facility Providers
Date: 12/19/23
Effective for dates of services December 1, 2023 and after, AHCCCS is requiring BHRFs, Provider Type B8, to submit claims for H0018 with POS 56 “Psychiatric Residential Treatment” instead of POS code 99 “Other Place of Service.” This change impacts claims billed with H0018 only.
Claims for H0018 prior to December 1, 2023, are still required to be billed with POS 99 “Other Place of Service.”
Claims for H0018 that span dates of service before and after December 1, 2023 will need to be split billed as follows:
- Claim 1: Dates of service before December 1, 2023, should be billed with POS 99
- Claim 2: Dates of service on or after December 1, 2023 should be billed with POS 56
The initial reference files we received from AHCCCS and loaded included an incorrect termination date of November 1, 2023 for POS 99 causing unexpected claim denials. The AHCCCS reference files have been corrected and we are in the midst of identifying and reprocessing impacted claims.
Please note that POS code 55 “Residential Substance Abuse Treatment” remains a valid POS and should be billed when appropriate.
Care1st providers and staff:
If you have questions, please call Network Management at 1-866-560-4042 (Options in order: 5, 7) or email us.