1. SERVICE DEFINITION AND SCOPE

Transitional Assistance Services in Arizona are defined as one-time, non-recurring set-up expenses for individuals transitioning from an institutional setting to a community-based home. The scope is limited to items and services that are essential to enable a person to establish a basic household and do not include ongoing rent or recreational items.

The service is strictly authorized for members enrolled in the ALTCS program who have lived in a Medicaid-funded institution for at least 90 consecutive days. Providers are responsible for coordinating the purchase and delivery of these items in alignment with the member's Case Manager and the formal transition plan.

• Benefit Limit: A one-time maximum allowance of $2,000 per member lifetime.
• Eligible Expenses: Security deposits for housing, essential household furnishings, and utility set-up fees.
• Excluded Items: Monthly rental payments, food, clothing, and home diversions or electronics.
• Service Timing: Must be provided within 180 days prior to discharge or immediately following the transition.

Coordination Requirement: Providers must work with the ALTCS Case Manager to ensure all purchases are documented in the Person-Centered Service Plan.

• Lead Agency: Arizona Health Care Cost Containment System (AHCCCS) oversees all Medicaid HCBS waivers.
• Partner Agency: Arizona Department of Economic Security (DES) Division of Developmental Disabilities (DDD) manages services for the ID/DD population.
• Federal Oversight: Centers for Medicare & Medicaid Services (CMS) provides the 1115 Waiver authority for ALTCS.
• Licensing Body: Arizona Department of Health Services (ADHS) licenses the parent facilities if the TAS provider is an existing health care institution.
• Contracting Entities: Managed Care Organizations (MCOs) like UnitedHealthcare and Arizona Complete Health manage daily provider operations.

3. LICENSURE AND CERTIFICATION REQUIREMENTS 

Arizona does not issue a specific 'Transitional Assistance Services' license. Instead, TAS is an allowable service category for providers already enrolled as HCBS entities or specialized transition agencies. Providers must be registered in the AHCCCS Provider Enrollment Portal (APEP) under the appropriate provider type, such as Provider Type 39 (Habilitation Provider) or other relevant HCBS categories.

While a specific TAS license does not exist, the entity must maintain a valid business license in the jurisdiction where they operate and meet all AHCCCS Minimum Subcontracting Standards. If the provider also offers residential services, they must be licensed by the Arizona Department of Health Services (ADHS) under Arizona Administrative Code (A.A.C.) Title 9, Chapter 10.

• License Status: No standalone TAS license exists in Arizona; approval is granted via APEP enrollment.
• Business License: Must maintain a current Transaction Privilege Tax (TPT) license from the Arizona Department of Revenue.
• Provider Type: Most TAS providers enroll as HCBS or Community Transition Service entities in APEP.
• ADHS Compliance: Residential providers offering TAS must comply with A.A.C. R9-10-800 for Assisted Living standards.
• Certification: Providers must sign the AHCCCS Provider Agreement and comply with the HCBS Settings Rule.

4. MEDICAID PROVIDER ENROLLMENT 

Enrollment is conducted exclusively through the AHCCCS Provider Enrollment Portal (APEP). This system replaced paper applications and serves as the single point of entry for all Arizona Medicaid providers. Applicants must first obtain a National Provider Identifier (NPI) and then complete the online APEP profile, which includes disclosures of ownership and control.

• Enrollment Portal: AHCCCS Provider Enrollment Portal (APEP) at https://www.azahcccs.gov/apep
• NPI Requirement: A Type 1 NPI for individuals or Type 2 NPI for organizations is mandatory per [How to Enroll with AHCCCS as a Healthcare Provider in Arizona](https://www.awmedbilling.com/blog-ahcccs-enrollment).
• Tax Documentation: A W-9 form signed within the last 12 months must be uploaded to APEP per [AHCCCS Provider Enrollment Applications and Revalidations](https://www.azahcccs.gov/APEP).
• Application Fee: A federal Medicaid provider enrollment fee (approximately $709 for 2024) may apply to institutional providers.
• EFT Enrollment: Providers must submit an Electronic Funds Transfer (EFT) authorization to receive payments.

5. STAFFING, TRAINING AND BACKGROUND CHECKS 

Staff members providing TAS must undergo rigorous background checks due to their direct contact with vulnerable ALTCS members. In Arizona, this specifically requires obtaining a Fingerprint Clearance Card (FCC) issued by the Arizona Department of Public Safety (DPS).

Training requirements focus on the AHCCCS Person-Centered Service Planning process. Staff must be able to demonstrate knowledge of the ALTCS transition process and the specific limitations of the TAS benefit to ensure members do not exceed their $2,000 lifetime cap.

• Fingerprint Clearance: All direct-service staff must hold a valid Level 1 Fingerprint Clearance Card from the Arizona DPS per [Arizona Medicaid Provider Enrollment 2026](https://medsolercm.com/blog/arizona-medicaid-provider-enrollment).
• Background Screening: Must check the OIG List of Excluded Individuals/Entities (LEIE) and the SAM exclusion list monthly.
• Training Standard: Staff must complete AHCCCS-mandated training on the HCBS Settings Rule and Member Rights.
• First Aid/CPR: Direct care workers must maintain current certification in First Aid and CPR.
• Abuse Reporting: Mandatory training on A.R.S. 46-454 regarding the reporting of abuse and neglect of vulnerable adults.

6. DOCUMENTATION, POLICIES AND RECORDS 

TAS providers must maintain meticulous records of all purchases and services rendered. Because TAS is a one-time benefit, AHCCCS auditors focus heavily on the 'Transition Plan' and the 'Member Acknowledgment' forms, which prove the member received the items requested.

Financial records must include original receipts for every item purchased using TAS funds. These records must be retained for at least six years in accordance with AHCCCS record retention policies and must be made available for post-payment review by the MCO or the AHCCCS Office of the Inspector General.

• Transition Plan: A copy of the ALTCS Case Manager's authorized transition plan must be in the provider file.
• Purchase Receipts: Original, itemized receipts for all furniture, deposits, and household goods.
• Member Acknowledgment: A signed statement from the member or legal guardian confirming receipt of all TAS items.
• Policy Manual: Providers must have written policies for member grievance procedures and incident reporting.
• Retention Period: Records must be kept for 6 years from the date of the last claim payment.

7. BILLING, RATES AND CLAIMS 

Billing for TAS in Arizona is typically done using HCPCS code T2038 (Community Transition, per service). Providers do not bill AHCCCS directly; instead, they submit claims to the member's assigned ALTCS Managed Care Organization (MCO) after the service has been authorized and the member has successfully transitioned.

• Billing Code: HCPCS T2038 is the standard code for Community Transition Services in Arizona.
• Claim Form: Professional claims are submitted via the CMS-1500 form or the 837P electronic format.
• Authorization: Prior authorization from the MCO Case Manager is mandatory before any funds are spent.
• Payment System: Claims are processed through the MCO's claims system, not the AHCCCS PMMIS directly.
• Timely Filing: Claims must typically be submitted within 180 days of the service date, depending on the MCO contract.

8. APPROVAL SEQUENCE AND TIMELINE 

The approval process begins with APEP enrollment and ends with MCO contracting. The initial APEP application typically takes 60 to 90 days to process, provided all documentation is complete. High-risk providers requiring site visits may see timelines extend to 120 days.

• Step 1: Obtain NPI and register for an APEP account (1-7 days).
• Step 2: Submit complete APEP application with W-9 and FCC (60-90 days per [Arizona Medicaid Provider Enrollment 2026](https://medsolercm.com/blog/arizona-medicaid-provider-enrollment)).
• Step 3: Pass AHCCCS screening and receive AHCCCS Provider ID.
• Step 4: Submit credentialing packets to ALTCS MCOs (30-90 days).
• Step 5: Execute MCO provider agreement and receive authorization for first member transition.

9. COMMON DENIALS AND SURVEY FINDINGS 

The most common reason for TAS provider denial in Arizona is incomplete documentation in the APEP portal, particularly regarding the Fingerprint Clearance Card or the W-9 form. AHCCCS will close inquiries that are missing required fields, forcing the provider to restart the 60-day clock.

• APEP Rejection: Missing or expired Fingerprint Clearance Cards for key personnel.
• W-9 Errors: Tax ID (TIN) in APEP does not match the IRS records or the W-9 form provided.
• Authorization Mismatch: Billing for T2038 without a corresponding Prior Authorization (PA) in the MCO system.
• Audit Recoupment: Failure to produce original receipts for household goods purchased for the member.
• Duplicate Billing: Attempting to bill TAS for a member who has already exhausted their $2,000 lifetime limit.

10. KEY CONTACTS AND RESOURCES 

Providers should utilize the AHCCCS Provider Enrollment unit for all questions regarding the APEP portal and initial ID issuance. For questions regarding specific member authorizations and TAS limits, the provider must contact the Provider Relations department of the specific MCO.

The AHCCCS Medical Policy Manual (AMPM) Chapter 1200 provides the authoritative policy guidelines for HCBS services, including the specific requirements for Community Transition Services.

AHCCCS Provider Enrollment: Phone (602) 417-7670 or email PRWebSupport@azahcccs.gov

APEP Portal Support: Online help desk and 'AVA' virtual assistant at https://www.azahcccs.gov/APEP

DES/DDD Provider Relations: Phone (844) 770-9500 for developmental disability service questions.

Mercy Care ALTCS : Primary MCO contact for Central Arizona transitions.

Banner-University Family Care: Primary MCO contact for Southern Arizona transitions.