ARP Provider Payment Information 2023 (Updated 07/20/2023)

In its American Rescue Plan (ARP) Act Home and Community Based Services (HCBS) spending plan, AHCCCS received federal approval to allocate almost $1.3 billion over three years in one-time provider payments to recruit and retain a knowledgeable and well-trained workforce. This amount is subject to change pending additional modifications made to the HCBS Spending Plan. These time-limited payments will be made in State Fiscal Years (SFY) 2022, 2023, and 2024. AHCCCS anticipates making the SFY 2023 payments in the spring of 2023.

The SFY 2023 provider payments total more than $500 million and will be paid by the AHCCCS managed care organizations (MCOs) and the fee-for-service (FFS) administration to providers serving members enrolled in all AHCCCS programs who are active providers in good standing. Of note, the Department of Economic Security/Division of Developmental Disabilities (DES/DDD) will make direct payments to its contracted providers using a methodology similar to that used by AHCCCS. Providers should also note that SFY 2024 payments may be different from the SFY 2023 payments.

The AHCCCS managed care provider payments, called “directed payments,” will be computed by applying a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from a specified time period for select ARP qualifying codes. For SFY 2023 key components of calculations are included below:

  • The flat percentage is 11%,
  • The specified time period is dates of service from March 1, 2022 through August 31, 2022. The six months of data will be doubled to approximate a full year of payments, and
  • There are nearly 70 qualifying procedure codes summarized by category.

Approximately 1,500 AHCCCS managed care providers are expected to qualify for SFY 2023 payments. Based on this significant number of impacted providers, and the application of nearly 70 procedure codes, only approved and adjudicated encounters in the AHCCCS database will be utilized in the computations. AHCCCS will not consider any other data when computing payments, including validation or verification of provider computations. Provider payments may be made by multiple MCOs and involve multiple transactions in the same proportion that claims payments from the specified period were received

Approximately 3,570 provider agencies will receive one-time, directed payments from DES/DDD utilizing a similar methodology, though the percentage rate applied to prior Medicaid payments will vary by service category.

Working within federal and state guidelines, AHCCCS has developed the methodology for making time- limited payments to fee-for-service (FFS) providers. FFS provider payments will utilize the same ARP qualifying services as those identified for the AHCCCS managed care Directed Payments for eligible providers. Both non-Indian Health Service /638 tribal (IHS/638) providers, and IHS/638 providers, could be eligible for payment.

All information contained in this notice is subject to change if any amendments to the ARP HCBS spending plan impact available funding. In addition, the total payment amount across all three years, the SFY 2023 payment values, and the SFY 2023 payment percentages, are subject to change.

ARP Directed Payment Provider Guidance 2023

Guidance regarding ARP provider payments as authorized by Laws 2022, Second Regular Session, Chapter 2 and the Centers for Medicare and Medicaid Services (CMS) through 438.6(c) is available at the links provided below. To the extent that CMS requires changes to the payment methodology and/or process, this guidance may be updated.

These SFY 2023 payments are one-time payments for HCBS and Rehabilitation providers. AHCCCS does not intend to continue this level of funding permanently.

The Provider Directed Payment Guidance available at the link below is for all lines of business, except ALTCS-DD. The DES/DDD issued its own guidance and requirements for ALTCS-DD providers, which can be found on the DDD ARP web page.

As outlined in this AHCCCS guidance, there are requirements regarding how the funds are to be utilized. Eligible providers must attest that they will follow these guidelines. The eligible providers included in the Individual Eligible Providers with NPI (Non-DDD and DDD Subcontracted Health Plan) list (link below) are providers contracted through the MCOs.

AHCCCS has developed a similar process for providers reimbursed through the FFS program. Providers who serve both MCO and FFS members will be required to complete two attestations. One related to MCO payments and a second related to FFS payments. The FFS ARP Provider Attestation 2023 will be posted in April 2023.

ARP Provider Payment Resources 2023 (Revised 07/20/2023

Provider questions about ARP Directed Payments can be emailed to: