Currentblue cross blue shield - arizonaPolicy N/A

Traditional Healing Services coverage for AHCCCS members

This document announces coverage and billing guidance for Traditional Healing Services for Arizona Medicaid (AHCCCS) beneficiaries delivered by or through IHS, Tribal 638 facilities, and affiliated organizations; it affects providers billing Blue Cross Blue Shield of Arizona for AHCCCS members.

Policy Summary

Payerblue cross blue shield - arizona

PolicyTraditional Healing Services coverage for AHCCCS members

Policy CodePolicy N/A

Change TypeCoverage addedcoding updates

Effective DateOct 1, 2025

Next Review Date

Key ActionRefer to the AHCCCS 'Traditional Healing Services Billing Overview' for billing and reimbursement procedures.

SourceLink

POLICY UPDATE CHANGES

AHCCCS announced coverage of Traditional Healing Services for eligible members effective October 1, 2025.

AHCCCS opened new tribal-specific H-codes on January 1, 2026 as descriptor codes related to MMIP and indigenous historical trauma.

Oct 1, 2025Effective date for Traditional Healing Services coverage

Jan 1, 2026Date AHCCCS opened new tribal H-codes

3Primary provider settings/orgs listed (IHS, Tribal 638, UIOs)

Coverage Criteria for Traditional Healing Services

Policy Summary

Payerblue cross blue shield - arizona

PolicyTraditional Healing Services coverage for AHCCCS members

Policy CodePolicy N/A

Change TypeCoverage addedcoding updates

Effective DateOct 1, 2025

Next Review Date

Key ActionRefer to the AHCCCS 'Traditional Healing Services Billing Overview' for billing and reimbursement procedures.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coverage criteria summary

Covered when ALL of the following are met:

ALL of the following

Service is provided to an AHCCCS member eligible to receive services delivered by or through Indian Health Service (IHS) or a Tribal 638 facility, as determined by the facility.
Service delivered by or through one of the following provider types:
- Indian Health Service (IHS)
- Tribal 638 facility
- Urban Indian Organization (UIO) — when provided and billed through a Care Coordination Agreement with an IHS/638 facility.
Billed in accordance with AHCCCS 'Traditional Healing Services Billing Overview' guidance.

Effective date: services provided on or after October 1, 2025.

Provider Billing & Action Items

Billing Rule

Billing & provider billing pathway guidance

Providers must follow AHCCCS billing and reimbursement procedures for Traditional Healing Services. Refer to the AHCCCS 'Traditional Healing Services Billing Overview' for full guidance on required claims submission steps, documentation, provider types eligible to bill, and reimbursement pathways.

Eligible provider settings: inpatient and outpatient
Eligible providers: Indian Health Service (IHS), Tribal 638 facilities, Urban Indian Organizations (UIOs)
Traditional Healers affiliated with UIOs may bill through a Care Coordination Agreement with an IHS/638 facility
Follow AHCCCS billing overview for specific codes, claim form requirements, and documentation retention

Definitions — Eligible Members and Provider Settings

inv-04: Eligible members

Eligible membersMedicaid beneficiaries who are eligible to receive services delivered by or through Indian Health Service (IHS) or Tribal 638 facilities, as determined by the facility.

Determination of eligibilityEligibility is determined by the IHS or Tribal 638 facility delivering or coordinating the service.

Effective dateCoverage effective October 1, 2025 for eligible members.

inv-05: Eligible provider settings

Eligible provider settingsIndian Health Service (IHS); Tribal 638 facilities; Urban Indian Organizations (UIOs).

Service sitesEligible settings include both inpatient and outpatient service delivery.

UIO billing pathwayTraditional Healers affiliated with UIOs may provide and bill for services through a Care Coordination Agreement with an IHS/638 facility.

OpenPayer

Traditional Healing Services coverage for AHCCCS members

Coverage Criteria for Traditional Healing Services

HCPCS / Billing Codes

Provider Billing & Action Items

Definitions — Eligible Members and Provider Settings