We’re ready for you (and your billing company) over on Availity! With just a few more resources to move to Availity Essentials™, our portal transition is in its final stage. Once the transition is complete, users will no longer have access to the AZ Blue provider portal.
There’s a lot to like about Availity Essentials—see our provider FAQs for details. Need to get your organization registered? Visit availity.com/azblue or go straight to the Register and Get Started page. Please share this information with your billing company and ensure they have an Essentials account.
The Availity Client Service team is standing by to help you with registration and questions: 800-282-4548.
What’s new
FEP payment cycle update: Starting April 1, claim payments for Federal Employee Program® (FEP®) member services will be made once a week. Instead of twice weekly, payments will be made only on Tuesdays.
FEP timely filing moves to 90 days: Starting May 1, the standard timely filing time frame for FEP claims will be 90 days from the date of service. This aligns with the AZ Blue standard time frame for claim submission.
Incident-to services—recently revised policy: We have further revised the policy in response to questions about providers reimbursed as 1099 workers. See the 03/03/26 policy revision.
Prefix list update: We have added the two prefixes (HCI and MZH) associated with the Health Choice Network for Medicaid plans. See the updated list.
Condition code 1111F: This code documents the completion of medication reconciliation after discharge. Please include this code on the acute-care claim or send a separate “penny code” claim (bill code 1111F at $0.01) to support compliance with the Transitions of Care (TRC) HEDIS® measure. Be sure to include the NPI of the clinician who went over all post-discharge medication protocols with the patient (and family or caregivers). This will provide a valid record for our HEDIS reporting.
Sending us mail or a fax? Be sure to include your name, address, and phone and fax numbers so we can process your request.
Reminder about changes effective April 1
Specific documentation for ABA prior authorization requests: Starting April 1, applied behavioral analysis prior authorization requests must include specific documentation. See an overview and tips on what to include.
Note:Claims for ABA services are paid based on the approved weekly unit count that was authorized for each code to support medical necessity (not a cumulative number of units across the entire authorization period).
Claim pricing update: To better align with industry standards, the following update will be effective for service dates on or after April 1.
Radiopharmaceuticals and contrast agents: Certain non-therapeutic radiopharmaceuticals and contrast agents administered during an imaging procedure or nuclear medicine procedures rendered in a facility setting will be included in the reimbursement for the associated service. See the updated Included Services list.
2026 Part B step therapy policy: The recently revised 2026 Part B step therapy list reflects these updates, effective April 1:
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Denosumab: Added Enoby™ and Xtrenbo™ to the step 2 (non-preferred) list of biosimilars.
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Myasthenia gravis: Relaxed the step therapy requirements for certain medications and diagnoses.
Quarterly drug fee updates: You can preview the April 1 updates on the Availity Essentials portal. Read more.
Learning opportunities
Perinatal mental health: Designed to support maternal mental health in Arizona, this free, self-paced training takes you through three one-hour modules to help you deliver compassionate, effective care to this vulnerable population. See course and CE information for:
Availity is a separate, independent company contracted with AZ Blue for provider portal services. Availity is a registered service mark and Availity Essentials is a service mark of Availity, LLC.
Enoby and Xtrenbo are trademarks of Hikma Pharmaceuticals USA Inc.
Blue Cross, Blue Shield, the Cross and Shield Symbols, Federal Employee Program, and FEP are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
