Alaska Administrative Code

(a) Not later than 30 days before a home and community-based waiver services provider terminates services to a recipient, the provider shall send written notice of service termination to the department, the recipient, and the recipient's care coordinator. (b) provider may termina…

(a) The department may authorize nursing oversight and care management services for a recipient that is eligible under the recipient category of (1) children with complex medical conditions; or (2) individuals with intellectual and developmental disabilities if the recipient meet…

(a) An individual may not provide care coordination services unless (1) the department certifies the individual under this section; (2) the individual is enrolled in the Medicaid program under 7 AAC 105.210; and (3) the individual is an owner of or employed by a care coordination…

(a) The department will pay for care coordination services that are (1) provided in accordance with 7 AAC 130.217 and 7 AAC 130.218 and the department's Care Coordination Services and Long Term Services and Supports Targeted Case Management Conditions of Participation, adopted by…

Notes 7 AAC 130.245 Eff. 2/1/2010, Register 193; am 7/1/2013, Register 206; am 7/1/2015, Register 214, July 2015; am 11/5/2017, Register 224, January 2018; repealed 1/1/2021, Register 236, January 2021 State regulations are updated quarterly; we currently have two versions availa…

(a) The department will pay for adult day services that (1) are provided to a recipient in one of the following recipient categories: (A) older adults or adults with physical disabilities; (B) adults with physical and developmental disabilities; (2) are provided in accordance wit…

(a) The department will pay for residential supported-living services that (1) are provided to a recipient in one of the following recipient categories: (A) older adults or adults with physical disabilities; (B) adults with physical and developmental disabilities; (2) are provide…

(a) The department will pay for day habilitation services that (1) are provided to a recipient in one of the following recipient categories: (A) children with complex medical conditions, if the recipient is three years of age or older; (B) adults with physical and developmental d…

(a) The department will pay for residential habilitation services that (1) are provided to a recipient in one of the following recipient categories: (A) children with complex medical conditions; (B) adults with physical and developmental disabilities; (C) individuals with intelle…

(a) The department will pay for additional services under this section that (1) are provided for a recipient who is qualified under (b) of this section and is receiving (A) residential supported-living services under 7 AAC 130.255 that are assigned the procedure code described in…

(a) The department will pay for employment services if they are (1) provided in accordance with the department's Employment Services Conditions of Participation, adopted by reference in 7 AAC 160.900; (2) provided to a recipient in one of the following recipient categories:(A) ch…

(a) The department will pay for intensive active treatment services (1) that are provided to a recipient in one of the following recipient categories: (A) adults with physical and developmental disabilities; (B) individuals with intellectual and developmental disabilities 21 year…

(a) The department will pay for respite care services that (1) are provided in accordance with the department's Respite Care Services Conditions of Participation, adopted by reference in 7 AAC 160.900; (2) are approved under 7 AAC 130.217 and 7 AAC 130.218 as part of the recipien…

(a) The department will pay for specialized private-duty nursing services that (1) are provided to a recipient 21 years of age or older that meets the requirements of 7 AAC 110.525(a) (2) - (4) and that is in one of the following recipient categories: (A) adults with physical and…

(a) The department will pay for transportation services that (1) are provided in accordance with the department's Transportation Services Conditions of Participation, adopted by reference in 7 AAC 160.900; (2) are approved under 7 AAC 130.217 and 7 AAC 130.218 as part of the reci…

(a) The department will pay for meal services that (1) are provided to a recipient 18 years of age or older; (2) are provided in accordance with the department's Meal Services Conditions of Participation, adopted by reference in 7 AAC 160.900; (3) are approved under 7 AAC 130.217…

(a) The department will pay for environmental modification services that (1) are provided in accordance with the department's Environmental Modification Services Conditions of Participation, adopted by reference in 7 AAC 160.900; (2) are approved under 7 AAC 130.217 and 7 AAC 130…

(a) The department will pay for specialized medical equipment that (1) is supported by a prescription or other written documentation required by the department's Specialized Medical Equipment Fee Schedule, adopted by reference in 7 AAC 160.900, (A) from an individual with an acti…

Notes 7 AAC 130.310 Eff. 2/1/2010, Register 193; repealed 7/1/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will…

In this chapter, unless the context requires otherwise, (1) "active teaching or training" means the use of appropriate measures or interventions that are evidence-informed, address objectives described in a recipient's approved support plan, lead to positive outcomes, and engage …

(a) The department will pay for a behavioral health service under 7 AAC 135.010 - 7 AAC 135.370 if (1) the recipient meets the criteria for services under 7 AAC 135.020; (2) the provider meets the criteria for payment under 7 AAC 135.030; (3) the service is identified as a treatm…

(a) The department will pay for behavioral health clinic services for the following individuals only: (1) a child experiencing an emotional disturbance; (2) a child experiencing a severe emotional disturbance; (3) an adult experiencing an emotional disturbance; (4) an adult exper…

(a) To be eligible for payment under 7 AAC 135.010 - 7 AAC 135.370 for providing Medicaid behavioral health services, a provider must be enrolled in Medicaid under 7 AAC 105.210 and must be either (1) a community behavioral health services provider; (2) a mental health physician …

(a) Except as provided in (b) and (c) of this section and 7 AAC 105.130(d), the department will not pay for behavioral health services unless the department has given prior authorization for those services. (b) A community behavioral health services provider or mental health phys…

An adult experiencing an emotional disturbance is an individual 21 years of age or older who is experiencing a nonpersistent mental, emotional, or behavioral disorder that (1) is identified and diagnosed during a professional behavioral health assessment under 7 AAC 135.110; and …

(a) An adult experiencing a serious mental illness is an individual 21 years of age or older who currently has or at any time during the past year has had a diagnosable mental, emotional, or behavioral disorder of sufficient duration to meet diagnostic criteria specified in the D…

A child experiencing an emotional disturbance is an individual under 21 years of age who is experiencing a nonpersistent mental, emotional, or behavioral disorder that (1) is identified and diagnosed during a professional behavioral health assessment under 7 AAC 135.110; and (2) …

(a) A child experiencing a severe emotional disturbance is an individual under 21 years of age who currently has or at any time during the past year has had a diagnosable mental, emotional, or behavioral disorder of sufficient duration to meet diagnostic criteria specified in the…

(a) The department will pay a provider listed in 7 AAC 70.010(a) and an eligible provider under 7 AAC 105.200 for conducting a behavioral health screening with a new or returning recipient using a screening tool recommended by the department or identified by the provider as appro…

(a) If an individual requests treatment, or is referred by a court or other agency, as an individual who is suspected of having a behavioral health disorder that could require behavioral health services, the department will pay (1) a community behavioral health services provider …

(a) The department will pay a community behavioral health services provider or a mental health physician clinic for services provided to a recipient only if (1) those services are provided under an individualized behavioral health treatment plan that meets the requirements of thi…

(a) To be eligible for payment under this chapter, a community behavioral health services provider or a mental health physician clinic must maintain, for each recipient served, a clinical record in accordance with 7 AAC 105.230 that also must include a (1) written report that doc…

(a) The department will pay a community behavioral health services provider or mental health physician clinic for a pharmacologic management service if that service is provided directly by a professional described in 7 AAC 135.010(b) (2). (b) To qualify for payment under this sec…

(a) The department will pay a community behavioral health services provider or mental health physician clinic for one or more of the following forms of psychotherapy, as coded in Current Procedural Terminology (CPT), adopted by reference in 7 AAC 160.900: (1) insight-oriented ind…

(a) The department will pay a community behavioral health services provider or mental health physician clinic for short-term crisis intervention services, provided by a mental health professional clinician to a recipient, if that mental health professional clinician provides an i…

(a) The department will pay a community behavioral health services provider for short-term crisis stabilization services, provided by a substance use disorder counselor or a behavioral health clinical associate to a recipient, if that substance use disorder counselor or behaviora…

(a) The department will pay a community behavioral health services provider for case management provided to a recipient or recipient's family for one or more of the following purposes only: (1) coordinating assessments, treatment planning, and service delivery; (2) providing link…

(a) A community behavioral health services provider may only bill the department for the following alcohol and drug withdrawal management services delivered face-to-face to the recipient if the services are provided in accordance with this section: (1) level 1 withdrawal manageme…

Notes 7 AAC 135.200 Eff. 10/1/2011, Register 199; am 4/24/2020, Register 234, April 2020; repealed 6/30/2021, Register 238, July 2021 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the p…

(a) A community behavioral health services provider may only bill the department for peer support services if those services (1) include (A) one-on-one, family, or group activities designed to assist the recipient attain identified treatment goals; (B) assisting the recipient or …

(a) The department will pay a community behavioral health services provider for therapeutic behavioral health services, for a recipient under 21 years of age with a severe behavioral disorder, if those services (1) improve the recipient's overall functioning and reduce the likeli…

Notes 7 AAC 135.230 Eff. 10/1/2011, Register 199; am 6/16/2016, Register 218, July 2016; repealed 6/30/2021, Register 238, July 2021 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the pr…

(a) A community behavioral health services provider, a mental health physician clinic. or an individual identified in 7 AAC 135.910 may only bill the department for screening and brief intervention services if that provider conducts the screening component and, if needed, the bri…

(a) The department will pay a community behavioral health services provider for day treatment services for children provided in the school setting if those services (1) are provided to a recipient who is a child experiencing a severe emotional disturbance; (2) promote the recipie…

(a) The department will pay a community behavioral health services provider for on-premises medication administration services provided to a recipient on the premises of the community behavioral health services provider. (b) The department will pay a community behavioral health s…

Notes 7 AAC 135.270 Eff. 10/1/2011, Register 199; am 11/3/2012, Register 204; repealed 6/30/2021, Register 238, July 2021 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarter…

(a) The department will pay a community behavioral health services provider for residential substance use disorder treatment services if the provider is operating a structured residential program to treat substance use disorders in accordance with 7 AAC 70.120. (b) To qualify for…

Notes 7 AAC 135.290 Eff. 10/1/2011, Register 199; repealed 4/24/2020, Register 234, April 2020 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison…

(a) To qualify for payment for autism services, a provider must be a community behavioral health services provider, a behavior analyst who meets the requirements in (c) of this section, or a behavior analyst group practice enrolled under 7 AAC 105.210. If the provider is (1) a co…

(a) The department will pay for the following rehabilitative autism services provided to a recipient listed in 7 AAC 135.020(e) or (f) if provided by a provider identified in 7 AAC 135.300; (1) initial behavior identification assessment; (2) behavior identification reassessment; …