Get Ahcccs Provider Participation Agreement 2020-2024

Contact Us For Online Provider Enrollment/Application Payment Questions: Call: Maricopa County: 602-417-4254. Statewide: 1-888-827-4420. Write: AHCCCS Provider Enrollment Fee. 701 E. Jefferson, MD 5400. Phoenix, AZ 85034.

ALTCS is an Arizona Health Care Cost Containment System (AHCCCS) Medical Assistance Program. ALTCS provides long term services to eligible individuals who meet financial and medical requirements, are developmentally disabled, and have a medical need.

If your family's income is at or below 138% of the Federal Poverty Guidelines (FPG) ($20,120 for an individual; $41,400 for a family of four), you may be able to get AHCCCS coverage.

Children who are 18 or younger can get AHCCCS KidsCare coverage if their family's income is 205% of FPG or less ($61,500 per year or less for a family of four). Income-based AHCCCS counts most types of earned and unearned income you have.

Income Limits Household SizeGross Monthly Income Limit Effective 02/01/20231$1,6162$2,1863$2,7564$3,5252 more rows

Income information is first collected from the Federal and State Data Services Hubs, if available, and compared to the income reported by the customer. When the customer reports income that is over the income limits for AHCCCS Medical Assistance (MA), it is reasonably compatible. No further proof is needed.

For members and services covered by Medicare, providers must bill Medicare first. When payment is received, providers may bill AHCCCS for the coinsurance/copay and deductible as shown on the Medicare RA/EOMB. Providers must attach a copy of the Medicare RA/EOMB to the UB-04 claim.

Earned income is received from employment or self-employment. It may be received as wages, salaries, commissions or profits. NOTE Earned income may also be received as goods or services other than cash in return for work.