Billing Requirement Change for IC, 77 and 05 Provider Types
Applicable To: Mercy Care Complete Care, Mercy Care DD, Mercy Care DCS CHP, Mercy Care Long Term Care and Mercy Care RBHA
Effective for dates of service on or after 3/1/22, AHCCCS has changed their billing requirements regarding IC, 77 and 05 Provider Types.
In order to retain information related to the actual professional practitioner (provider) participating in/performing services associated with clinic visits reported with the IC, 77 or 05 provider type as the service/rendering provider, that professional practitioner (provider) participating in/performing services must also be reported on all claims. Please review the following for additional detail:
AHCCCS Fee For Service Manual: Exhibit 10-1 Participating Provider Information - Provider Types IC, 77 and 05. Examples on how to bill are included.
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