Certified Community Health Workers & employed by AHCCCS registered providers can now bill for reimbursable services! Claims for covered services provided by the certified CHW or CHR need to be given by the registered AHCCCS provider. A CHW or CHR can be employed by multiple AHCCCS registered providers. AHCCCS registered providers may employ multiple CHWs or CHRs.
In order to obtain Medicaid reimbursement, the CHW needs to be certified by ADHS and may only deliver covered services within their scope of practice under specified AHCCCS registered provider types.
These provider types are listed in question 8 of the CHW/CHR Frequently Asked Questions.
The employer may only submit claims using the allowed codes for the covered services provided by its CHWs or CHRs. Additional billing guidance will be added to the AHCCCS Fee-for-Service Provider Billing Manual.
Answers to Key Questions about Integrating CHWs into the Network of Care
- How does a CHW/CHR obtain voluntary certification?
- What provider types can bill for CHW/CHR services?
- How does a CHW/CHR organization become an AHCCCS-registered provider?
- How does an employer bill for CHW/CHR services? If I have additional questions about Medicaid reimbursement for CHW/CHRs, who should I contact?
