Provider | Resources | Claims And Remits

Claims and Remits

In addition to claim status and online remit tools, we offer resources to help you understand requirements for claim submission, coding, and pricing.

TYPE OF PLAN	HOW TO ACCESS
AZ Blue Plans FEP Plans BlueCard (Out-of-Area) Plans	Availity Essentials Portal AZ Blue Provider Portal
ACA StandardHealth with Health Choice Plan (prefix IAZ)	Health Choice Provider Portal
Medicare Advantage Plans (prefix M2K)	For plans administered by AZ Blue: Availity Essentials Portal Other plan administrators: Arizona Priority Care (AZPC) Optum Health Network Arizona (OHNAZ)
Corporate Health Services (CHS) Group Plans (no prefix)	Contact the third-party administrator (TPA) named on the member ID card or use our search tool to find the TPA contact information: CHS Group - TPA Information Finder
BlueDental^SM Stand-Alone Plans (prefix 99D)	BlueDental Provider Portal

Content restricted by user role or network status (or both).

TYPE OF PLAN	HOW TO ACCESS
AZ Blue Plans Federal Employee Program^® (FEP^®) Plans BlueCard^® (Out-of-Area) Plans Medicare Advantage Plans	For payments made after July 8, 2024: Availity Essentials™ Portal AZ Blue Provider Portal
ACA StandardHealth with Health Choice Plan (prefix IAZ)	Health Choice Provider Portal
Corporate Health Services (CHS) Group Plans (no prefix)	Contact the third-party administrator (TPA) named on the member ID card or use our search tool to find the TPA contact information: CHS Group - TPA Information Finder
BlueDental Stand-Alone Plans (prefix 99D)	BlueDental^SM Provider Portal

Content restricted by user role or network status (or both).

Outpatient Coding Guide (select edition below)

Content restricted by user role or network status (or both).

All content below requires a login and is restricted by user role or network status (or both).

Claim Pricing (AZ Blue Provider Operating Guide Section 20)

FEES	OUTPATIENT GLOBAL PRICING	OTHER PROPRIETARY PRICING GUIDELINES
Fee Schedule Tool Fee Updates-ASC Fee Updates-Outpatient Fee Updates-Professional Fee Updates-Unclassified Drug Fee Updates-Per Diem Base Rates	Outpatient Global Pricing Guidelines Global Surgical Code Lists Minor Procedure Code Lists Revenue Code 0274 or 0278-CPT or HCPCS Lists	DME Months to Purchase List Included Services Guidelines and List Inpatient Unbundling Guidelines Modifier Pricing Actions Single Units of Service CPT and HCPCS Lists Single Units of Service Revenue Code Table

ANESTHESIA	MODIFIERS	OTHER STANDARD PRICING GUIDELINES
Anesthesia Base Units Lists (PDF) Anesthesia Pricing Guidelines (PDF) Maternity Epidural Anesthesia Pricing Guidelines (PDF)	Assistant Surgeon List 2025 January-Current (PDF) Previous versions: Assistant Surgeon List 2024 September (PDF) 2024 April (PDF) 2024 January (PDF) 2023 July Revised (PDF) 2023 January Revised (PDF) 2022 March (PDF) 2022 January (PDF) 2021 July (PDF) 2021 January Revised (PDF) 2020 July (PDF) 2020 January (PDF) Modifier 22 – Increased Procedural Services Guidelines (PDF) Modifier 26 TC Lists (Excel) Modifier 50 Table 2024 April-Current (PDF) Previous versions: 2024 January (PDF) 2023 July Revised (PDF) 2023 January Revised (PDF) 2022 July (PDF) 2022 April (Excel) 2022 January (PDF) 2021 July (PDF) 2021 January (PDF) 2020 October (PDF) 2020 July (PDF) 2020 January (PDF) Modifier 62 or 66 Pricing Guidelines (PDF) Modifier 63 Pricing Guidelines (PDF)	Consultation Pricing Guidelines (PDF) Drug Urine Screening Test Pricing Guidelines (PDF) Emergency Department Leveling Policy (PDF) Mammography Pricing Guidelines (PDF) Obsolete Pharmacy CPT/HCPCS Code Lists September 2024 - Current (PDF) Previous versions: 2024 July (PDF) 2023 August (PDF) Same Day Readmission Pricing Guidelines (PDF) TENS Supply Pricing Guidelines (PDF)