Provider billing guides and fee schedules

This page contains billing guides, fee schedules, and additional billing materials to help you submit:

  • Prior authorization (PA) for services
  • Claims

Notice: Billing guides with dates prior to October 1, 2016, will have broken links. If this occurs, please refer to the most recent guide.

Stay up-to-date with rate and billing changes, and ProviderOne system changes.

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Prior authorization (PA)

Before you provide certain services, you will need to submit authorization request forms. Use the ProviderOne portal to see if a client is eligible for the service and the billing guides and fee schedules to determine if a PA is required.

For step-by-step instructions on completing a PA, visit our Prior authorization (PA) page.

Do you need a PA form? Visit our Forms and publications page to download authorization forms.


After you complete a service, you file claims through the ProviderOne portal. Use the billing guides and fee schedules to find rate information and the ProviderOne Billing and Resource Guide to walk through the claims process.

Do you need a barcode cover sheet? Visit our Document submission cover sheets page to find the barcode cover sheets required with additional documentation.

Billing guides and fee schedules

Use our billing guides and fee schedules to determine if a PA is required and assist in filing claims. 

Questions? For questions about billing guides, contact the Medical Assistance Customer Service Center (MACSC) online or at 1-800-562-3022. For questions about rates or fee schedules, email

The following items are found in other guides and no longer listed separately:

    Jump to the first list item for each letter: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

    Billing guides

    Discontinued 4/1/2013. Refer to the current Physician-related/professional services for information regarding blood, blood products, and related services.

    Fee schedules

    Billing guides

    Physician-related/professional services fee schedules

    Enhanced pediatric fee schedules

    Medication assisted treatment (MAT) fee schedules

    Conversion factors

    Additional materials

    Billing guides

    Apple Health (Medicaid) expedited authorization (EA) lists

    For previous versions, email us

    Apple Health (Medicaid) preferred drug lists (PDLs)

    Managed care plans and fee-for-service (FFS) plans

    If you can't find the drug you are looking for on the Apple Health PDL, contact the managed care plan. For the FFS plan, see the FFS lists below.

    Fee-for-service (FFS) 

    For previous versions, email us

    FFS state maximum allowable cost (SMAC) list

    To request an FFS change in reimbursement

    Download the Pharmacy Information Authorization form (13-835A). Fax the request to: 866-668-1214.


    For fee schedule and rate questions
    For all other provider questions
    Medical Assistance Customer Service Center (MACSC)
    Online: web form
    Phone: 1-800-562-3022