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(a) Subject to AS 47.05, AS 47.07, and this chapter, the division will reimburse for outpatient nutrition services provided to a Medicaid recipient under 21 years of age who
(1) has an EPSDT screening under 7 AAC 43.452 within the 12 months before or one month after service is provided; and
(2) is determined to be at high risk nutritionally by a physician, advanced nurse practitioner, or other licensed or certified health care practitioner who may order those services within the scope of the practitioner's license or certification.
(c) Subject to AS 47.05, AS 47.07, and this chapter, the division will enroll as a provider of nutrition services a dietitian or nutritionist who
(1) is licensed under AS 08.38; and
(2) practices individually or in a group.
(d) Subject to AS 47.05, AS 47.07, and this chapter, the division will reimburse for the following nutrition services:
(1) one initial assessment in a calendar year;
(2) up to 12 hours of services subsequent to the initial assessment for counseling and follow-up care in a calendar year unless additional visits are prescribed by a physician, advanced nurse practitioner, or other licensed health care practitioner who may order those services within the scope of the practitioner's license.
(e) The division will reimburse an independently practicing enrolled provider of nutrition services directly. If an enrolled provider of nutrition services provides services as a member of the staff of a hospital or other facility that is an enrolled Medicaid provider, the division will make payment to the facility. The division will not separately reimburse for inpatient nutrition services provided to a patient in a hospital or nursing home.
(f) The division will reimburse an in-state enrolled provider of nutrition services at the lesser of the charge to the general public or $50 for the first 30 minutes of an initial assessment, $25 for each additional 15 minutes of the initial assessment, and $17.50 for each 15 minutes of services following the initial assessment.
History: Eff. 12/31/92, Register 124; readopt 8/7/96, Register 139; am 6/26/98, Register 146; am 3/3/2001, Register 157
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.454 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.
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Last modified 7/05/2006