A: AHCCCS will start reimbursing traditional healing services on October 1, 2025.
A: Traditional healing services must be provided by healers who are employed by or contracted with an Indian Health Service (IHS)/638 facility. Healers affiliated with an Urban Indian Organization (UIO) may also provide services through a Care Coordination Agreement (CCA) with an IHS/638 facility.
A: AHCCCS members who qualify for services at an IHS/638 facility are eligible. Members enrolled in AHCCCS Complete Care (ACC) plans may receive traditional healing services, except for those enrolled in the Federal Emergency Services Program (FESP), who are not eligible.
A: Each IHS/638 facility will work with its local Tribal community to decide which services are appropriate for Medicaid reimbursement. These may include ceremonial consultations, traditional counseling, sweat lodge services, and other culturally significant healing practices.
A: No. Eligible members in any AHCCCS health plan may receive traditional healing services. Reimbursement depends on the member’s health plan at the time the service is provided.
A: You can email your questions to TribalRelations@AHCCCS.gov.
A: The AIR is a flat rate used by IHS/638 facilities that covers all approved services during one visit. The FFS rate pays for individual services and follows the rules in the AHCCCS Fee-For-Service Manual.
A: No. There are no limits as long as the services are medically necessary and recommended by an AHCCCS registered provider.
A: Yes, Since Medicare does not cover traditional healing services, IHS/638 facilities do not need to submit claims to Medicare first when using revenue code 0509.
A: Yes. A claim may be submitted for each eligible member who received services in a group setting, as long as they were enrolled on the date of service.
A: AHCCCS is currently reviewing this. More guidance will be provided about using a group billing modifier with code H0051.
A: Use revenue code 0509 to identify traditional healing services provided to American Indian/Alaska Native (AI/AN) members.
A: No. Documentation must show that the service was medically necessary, but it does not have to follow the SOAP format.
A: No. Any AHCCCS registered provider working within their licensed scope of practice may refer a member for traditional healing services.
A: No. Traditional healers do not need to register individually with AHCCCS. Claims must use the National Provider Identifier (NPI) of the IHS/638 facility or clinic.
A: No. AHCCCS does not reimburse traditional healing services delivered via telehealth.
A: Facilities must establish a process to:
A: If a member has other insurance (excluding Medicare or Tribal Self Insurance), the claim must be sent to the primary insurance payer first. The provider will need to include the Explanation of Benefits (EOB) when submitting the claim to AHCCCS as the secondary payer.
