Alaska Admin. Code tit. 7, § 145.580 – Behavioral health services payment rates

(a) The department will pay a corresponding unit of service for providing community behavioral health services under 7 AAC 135.100 - 7 AAC 135.280, at the lesser of the following rates:
1. (1) the amount charged by the provider in accordance with 7 AAC 145.020; or
2. (2) the rate established in the department's Chart of Community Behavioral Health and Mental Health Physician Clinic Medicaid Covered Services Rates, adopted by reference in 7 AAC 160.900.
(b) Rates of payment in the department's Chart of Community Behavioral Health and Mental Health Physician Clinic Medicaid Covered Services Rates, adopted by reference in 7 AAC 160.900, will be reestablished at least every four years using a modeled rate methodology that includes components for salaries, fringe benefits, productivity, program support, administrative/general costs, and duration of units of service. Other sources that will be used in the modeled rate methodology include information from the Department of Labor and Workforce Development, Research and Analysis Section; the United States Internal Revenue Service; and provider surveys.
(c) Each July 1 that rates of payment in the Chart of Community Behavioral Health and Mental Health Physician Clinic Medicaid Covered Services Rates, adopted by reference in 7 AAC 160.900, are not reestablished under (b) of this section, the department will adjust the rates of payment in the Chart of Community Behavioral Health and Mental Health Physician Clinic Medicaid Covered Services Rates for inflation using the CMS Home Health Agency Market Basket in the most recent quarterly publication of the S&P Global Market Intelligence Healthcare Cost Review available 60 days before July 1.
(d) The department will pay a corresponding unit of service for providing autism services under 7 AAC 135.350 at the lesser of the following rates:
1. (1) the amount charged by the provider in accordance with 7 AAC 145.020; or
2. (2) the rate established in the department's Medicaid Procedure Codes and Rates - Autism Services, adopted by reference in 7 AAC 160.900.
(e) Repealed 6/30/2021.
(f) Each July 1, the department will adjust the rates of payment in the Medicaid Procedure Codes and Rates - Autism Services, adopted by reference in 7 AAC 160.900, for inflation using the CMS Home Health Agency Market Basket in the most recent quarterly publication of the S&P Global Market Intelligence Healthcare Cost Review available 60 days before July 1.

(Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199; am 4/9/2017, Register 222; am 5/21/2017, Register 222; am 7/1/2018, Register 226; am 1/1/2019, Register 228; am 7/1/2019, Register 231; am 10/25/2019, Register 232; am 4/24/2020, Register 234; am 6/30/2021, Register 238; am 5/25/2022, Register 242; am 2/2/2024, Register 249; am 1/5/2025, Register 253)

Authority: AS 47.05.010, AS 47.07.030, AS 47.07.040