Outpatient Hospital Fee Schedule (OPFS) Technical Information & FAQs

This section contains technical information related to the AHCCCS Outpatient Claim Reimbursement Project.

• Outpatient Hospital Fee Schedule Reference Extracts
  • AHCCCS Specific OPFS CCI Relationships
    • Excel Version [71KB]
    • PDF Version [14KB]
• Key Documents
  • Facility Peer Groups [PDF, 67KB]
  • OPFS Decision Tree (before 10/1/2011) [PDF, 72KB]
  • OPFS Decision Tree (after 10/1/2011) [PDF, 57KB]
• Frequently Asked OPFS Questions

For dates of service on and after 7/1/2005, AHCCCS reimburses in-state, non-IHS hospitals for outpatient services billed on a UB claim form using the AHCCCS Outpatient Hospital Fee Schedule. The Outpatient Hospital Fee Schedule will provide rates at the procedure code level, and Surgery/Emergency Department (ED) services will be bundled similar to Medicare for payment purposes . For more information on outpatient hospital billing requirements, refer to the AHCCCS FFS Provider Manual, Chapters 6 and 11, as well as the information listed as components of this webpage.

Contact

You are invited to e-mail us at AHCCCSOutpatientHospitalFeeSchedule@azahcccs.gov to provide comments following review of newly published information, or with any questions.