AHCCCS Medical Policy Manual (AMPM)

The AHCCCS Medical Policy Manual (AMPM) provides information to Contractors and Providers regarding services that are covered within the AHCCCS program. The AMPM is applicable to both Managed Care and Fee-for-Service members.

The AMPM should be referenced in conjunction with State and Federal regulations, other Agency manuals [AHCCCS Contractors' Operations Manual (ACOM) and the AHCCCS Fee-for-Service Manual], and applicable contracts.

Note: Information provided in PDF files.

"What's New" Memo

Revisions to the AMPM are completed on a periodic basis. The What's New memo describes the changes or additions being made.

What's New 2013-04 [12KB]
Thurs May 23, 2013

Updated versions of each chapter of the AMPM may be obtained below.

Download Entire Manual [Zip]

• Medical Policy Manual [9.9MB]

Download Individual Chapters [PDF]

• Manual Table of Contents [156KB]
• Chapter 100: Introduction [304KB]
• Chapter 200: Reserved
• Chapter 300: Medical Policy for Covered Services [3.05MB]
• Chapter 400: Medical Policy for Maternal and Child Health [1.69MB]
• Chapter 500: Care Coordination Requirements [698KB]
• Chapter 600: Provider Qualifications and Provider Requirements [491KB]
• Chapter 700: School Based Claiming Program/Direct Services Claiming [246KB]
• Chapter 800: Fee-For-Service Quality and Utilization Management [399KB]
• Chapter 900: Quality Management and Performance Improvement Program [1.5MB]
• Chapter 1000: Utilization Management Program [612KB]
• Chapter 1100: Federal Emergency Services (FES) Program [166KB]
• Chapter 1200: ALTCS Services and Settings for Members Who Are Elderly and/or Have Physical Disabilities and/or Have Developmental Disabilities [2.2MB]
• Chapter 1300: Member Directed Options [1.1MB]
• Chapter 1400: Reserved
• Chapter 1500: Reserved
• Chapter 1600: Case Management [1.4MB]
• Appendices
  • Appendices Table of Contents [12KB]
  • Appendix A, EPSDT and Adult Quarterly Monitoring Report Instructions & Template [275KB]
  • Appendix B, EPSDT Tracking Forms [1.5MB]
  • Appendix C, Reserved
  • Appendix D, Medical Foods Flow Charts [29KB]
  • Appendix E, Childhood and Adolescent Behavioral Health Tool Kits
    • Child ADHD [96KB]
    • Child Anxiety [76KB]
    • Child Depression [84KB]
  • Appendix F, Adult Behavioral Health Tool Kits
    • Adult ADHD [138KB]
    • Adult Anxiety [72KB]
    • Adult Depression [340KB]
    • Postpartum Depression [164KB]
  • Appendix G, Reserved
  • Appendix H, Policy for Management of Acute Behavioral Health Situations (NFS with No BH Units) [20KB]
  • Appendix I, Charts for Estimating Body Mass Index [330KB]
  • Appendix J, FFS Mileage Reimbursement Form [36KB]
  • Appendix K, Select ALTCS Case Management Forms in Spanish [548KB]
• Revision History
• Approved Policies Not Yet Effective