Medicare AdvantageCoverageHigh impact
Ambetter from Arizona Complete Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027
Ambetter·AZ · Psychiatry, PM&R (Physical Medicine & Rehab)·Claims & Billing
Effective date
Jan 1, 2027
We identified it
Aug 26, 2026
Summary
Effective January 1, 2027, Ambetter from Arizona Complete Health will discontinue coverage for 45 HCPCS H codes (primarily behavioral health and social services codes) while adding coverage for H0006. Billing teams must identify all claims using the discontinued codes and implement alternative billing strategies to avoid claim denials.
Action Required
By December 1, 2026: Billing team must audit all current claims and historical billing patterns to identify which of the 45 discontinued H codes (H0003-H0047, H1011, H2001-H2033 excluding H0006) are used in this practice. Update billing software to flag or block submission of these codes for Ambetter Arizona members effective 01/01/2027. Coordinate with clinical leadership and providers to identify alternative HCPCS codes or CPT codes for behavioral health and social services previously billed with H codes. Update claim submission workflows and encounter templates to prevent accidental billing of discontinued codes. Train billing staff on the change. Beginning 01/01/2027, do not submit claims with the 45 discontinued codes to Ambetter Arizona Complete Health—claims will be denied. Ensure H0006 is properly configured in billing system as a covered code starting 01/01/2027.