Due to scheduled maintenance at the State Data Center, azdhs.gov and associated services may be unavailable intermittently on Saturday, June 15th, between 9 a.m. and 5 p.m. We apologize for any inconvenience this may cause.
Bureau of Health Systems Development
Sliding Fee Schedule Information for Providers
A Sliding Fee Schedule (SFS) is used by medical providers offering discounted fees for services to persons without health insurance. The SFS determines, based on gross family income, the percentage or portion of billed charges that the uninsured client will be responsible for. Sliding Fee Schedules must be based on current Federal Poverty Guidelines and adhere to A.A.C. R9-1-504 Sliding Fee Schedule submission and content.
Federally Qualified Health Centers (FQHCs), FQHC-Look-Alikes (FQHC-LALs), National Health Service Corp sites, Arizona Loan Repayment sites and J-1 visa waiver sites are required to develop and implement a SFS and SFS policy as well as post a notice about the availability of a SFS in a visible location at their facility.
The Bureau of Health Systems Development can provide technical assistance and guidance on the development and implementation of sliding fee schedules and policies. Below are examples of a sliding fee schedule, a SFS policy and a SFS notice.
Note: Information above provided in PDF files.