Revision History and Archives
This page provides a summary of changes that have been made to this manual. Entries are added according to the date they were published. At the end of each entry you will find a link to a PDF file that archives the policy as it existed prior to the revision.
Revisions Date 08/18/2026
PEPM111 Provider Types [PT 14] Physical Therapist (PT)
PEPM111 Provider Types [PT 25] Group Home
PEPM111 Provider Types [PT 39] Habilitation
- OLCR HCBS and matching COS table added
PEPM111 Provider Types [PT A5] Behavioral Health Therapeutic Home
- COS 35 updated to “Adult Foster Care”. The COS title was a typographical error, this is not a change in available categories of service for behavioral health therapeutic homes.
PEPM111 Provider Types [PT AB] Applied Behavioral Analysis Org
- Signed and dated Applied Behavioral Analysis Org Provider Type Profile added to license/certification for category of service.
The following provider types have updated requirements for documentation required to add COS 31 (non-emergency transportation):
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 08/04/2026
PEPM111 Provider Types [PT CS] Certified School Counselor
PEPM111 Provider Types [PT SW] School Based Certified Social Worker
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 05/19/2026
PEPM302 Types of Modifications [Section A] Change in Ownership
- APEPTrainingQuestions@azahcccs.gov email address removed. Replaced with links to the AHCCCS Solutions Center.
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 04/28/2026
PEPM111 Provider Types [PT 47] Registered Dietician
- “American Dietetic Association” updated to “Commission on Dietetic Registration – Academy of Nutrition and Dietetics.”
PEPM111 Provider Types [PT 48] Nutritionist
- “American Dietetic Association” updated to “Commission on Dietetic Registration – Academy of Nutrition and Dietetics.”
PEPM111 Provider Types [PT 54] Affiliated Practice Hygienist
- Completed Affiliated Practice Dental Hygienist form submitted to the Arizona State Board of Dental Examiners added to License/Certification for COS. Letter of affiliation removed. ARS R4-11-609 added to Legal Authorities.
PEPM111 Provider Types [PT A5] Behavioral Health Therapeutic Home
- “Adult Foster Care homes” updated to “Adult Behavioral Health Therapeutic Homes.” Clarifying note added stating providers licensed as Adult Foster Care Homes must enroll as PT 50 Adult Foster Care Homes.
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 04/15/2026
PEPM111 Provider Types [PT CP] School Based Certified Psychologist
PEPM111 Provider Types [PT CS] Certified School Counselor
PEPM111 Provider Types [PT SW] School Based Certified Social Worker
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 03/03/2026
- Legal Authority 42 CFR Part 493 Subpart Q added to Site Visits
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 02/03/2026
PEPM111 Provider Types [PT 06] Emergency Transportation
- Information added regarding the ADHS Certificate of Necessity renewal.
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 01/20/2026
PEPM302 Types of Modifications [Section A] Change in Ownership
- Step/Action table added for reporting a change of ownership.
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 12/16/2025
- Application fee updated for 2026.
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 10/21/2025
PEPM111 Provider Types [PT 08] MD Physician
- Electronic Funds Transfer (EFT) added to Requirements. Clinical Laboratory Improvement Amendments (CLIA) Certificate added to Pathology & Lab Category of Service (COS).
- Language added instructing providers that an NPI application requires a taxonomy code. The taxonomy code listed in the APEP application should match the code listed in the NPPES. Term and definition added for “Taxonomy Code.”
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 08/12/2025
- Effective Dates section updated with examples of what may justify a retroactive enrollment date. Proof section updated with requirements before a retroactive enrollment date can be requested.
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 08/05/2025
- All managing employees of municipalities added to list of providers that require a criminal background check. Proof section updated to three years for previously submitted fingerprints to be accepted.
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 04/01/2025
- Taxpayer Identification Number (TIN) added to overview.
- New section added for Taxpayer Identification Number (TIN) information.
- Text added to reflect retroactive enrollment dates.
PEPM302 Types of Modifications [Section A] Change in Ownership
- Policy updated with information regarding when a provider gets a new TIN.
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 02/25/2025
PEPM111 Provider Types [PT 40] Attendant Care
- Note added to clarify when a provider can add COS 31.
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 01/31/2025
PEPM111 Provider Types [PT 02] Hospital
PEPM111 Provider Types [PT 71] Psychiatric Hospital
PEPM111 Provider Types [PT 78] Mental Health Residential Treatment Center (RTC)
PEPM111 Provider Types [PT B1] Residential Treatment Center Secure (17+ Beds)
PEPM111 Provider Types [PT B2] Residential Treatment Center Secure (1-16 Beds)
PEPM111 Provider Types [PT B3] Residential Treatment Center Non-Secure (17+ Beds)
PEPM111 Provider Types [PT B5] Subacute Facility (1-16 Beds)
PEPM111 Provider Types [PT B6] Subacute Facility (17+ Beds)
PEPM111 Provider Types [PT B7] Crisis Services Provider
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 01/30/2025
PEPM111 Provider Types [PT 02] Hospital
- License/Certification for COS 47 updated.
PEPM111 Provider Types [PT 71] Psychiatric Hospital
- License/Certification for COS 47 updated.
PEPM111 Provider Types [PT C4] Specialty Per Diem Hospitals
- Electronic Funds Transfer (EFT) added to Requirements. License/Certification for COS 47 updated.
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual
Revisions Date 01/29/2025
PEPM111 Provider Types [PT 02] Hospital
PEPM111 Provider Types [03 Pharmacy] Psychiatric Hospital
PEPM111 Provider Types [PT 78] Mental Health Residential Treatment Center (RTC)
PEPM111 Provider Types [PT B1] Residential Treatment Center Secure (17+ Beds)
PEPM111 Provider Types [PT B2] Residential Treatment Center Secure (1-16 Beds)
PEPM111 Provider Types [PT B3] Residential Treatment Center Non-Secure (17+ Beds)
PEPM111 Provider Types [PT B5) Subacute Facility (1-16 Beds)
PEPM111 Provider Types [PT B6] Subacute Facility (17+ Beds)
PEPM111 Provider Types [PT B7] Crisis Services Provider
PEPM111 Provider Types [PT C4] Specialty Per Diem Hospitals
For prior versions of the Provider Enrollment manual use this link:
Prior Version of the Provider Enrollment Policy Manual