Arizona Health Care Cost Containment System Prior Authorization Lookup
- Arizona Health Care Cost Containment System coverage criteria
- All Arizona Health Care Cost Containment System policy updates
Latest Arizona Health Care Cost Containment System prior authorization updates5
- Prior AuthReimbursement/Payment PolicyEff. 2023-10-30AHCCCS Reimbursement for Rapid Whole Genome Sequencing (rWGS)This policy governs AHCCCS reimbursement for medically necessary rapid whole genome sequencing (rWGS) provided to eligible Medicaid recipients in an inpatient hospital setting. It establishes clinical eligibility, prior authorization, separate billing, and payment requirements for hospitals.All Arizona Health Care Cost Containment System updates
- Prior AuthAdministrative/Operational PolicyAHCCCS Prior Authorization (PA) and Concurrent Review (CR) Standards during COVID-19 Emergency for Fee-for-Service Health ProgramsTemporary AHCCCS prior authorization, concurrent review, pharmacy, facility, transportation, home health, and durable medical equipment requirements during the COVID-19 public health emergency for Fee-for-Service members and providers.All Arizona Health Care Cost Containment System updates
- Prior AuthReimbursement/Payment PolicyBehavioral Health Administrative Days GuidanceClarifies reimbursement, billing, and prior authorization requirements for behavioral health administrative days and distinguishes them from traditional acute-care administrative days.All Arizona Health Care Cost Containment System updates
- Prior AuthClinical/Medical PolicyContinuous Blood Glucose Monitoring Devices (CGM)This prior authorization guideline governs coverage of continuous glucose monitors, sensors, and transmitters for AHCCCS Medicaid members in Arizona, including preferred and nonpreferred product criteria, reauthorization, quantity limits, billing instructions, and step therapy.All Arizona Health Care Cost Containment System updates
- Prior AuthClinical/Medical PolicyMedically Necessary Non-Emergency Transportation (NEMT) Coverage CriteriaThis policy governs AHCCCS coverage and prior authorization requirements for medically necessary non-emergency transportation when a member needs transportation to or from a covered medical or behavioral health service and cannot provide, secure, or pay for transportation.All Arizona Health Care Cost Containment System updates
Tool Description
Search Arizona Health Care Cost Containment Systemprior authorization policies by drug name, procedure, or policy title. Results include any policy that mentions prior authorization requirements (drug coverage criteria, imaging guidelines, site-of-service rules) not just documents titled “prior authorization.” Every result links to a full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Filter by payer, specialty, policy type, or effective year; or search directly for a drug (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee arthroplasty”), or a policy number.
Coverage spans 110+ payers. Jump straight to the busiest prior-auth publishers: UnitedHealthcare, Cigna, Aetna, Anthem, and Centene. You can also browse the full policy updates feed.
Pair a prior-auth search with the billing code lookup to confirm the CPT or J-code on the claim, the payer lookup for plan footprint, and payer profiles for contacts and coverage context.
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Prior auth requirements change all the time. Keep up with every payer policy update in the live policy feed, or browse payers with prior authorization policies.
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