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(a) Family planning services provided by a family planning clinic enrolled with the division will be reimbursed in accordance with 7 AAC 43.040, except that the division will pay 85 percent of the rate identified in the fee schedule established under 7 AAC 43.108.
(b) Contraceptive devices and supplies provided by a family planning clinic will be reimbursed in accordance with 7 AAC 43.040. The division will calculate maximum allowable rates for covered services by using the factors and formula described in 7 AAC 43.108. The division will reimburse an enrolled provider for procedures identified in the Medicaid Procedures Guide dated January 1999. The January 1999 version of the Medicaid Procedures Guide is adopted by reference. The descriptions and billing codes for these services are provided in the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 1998, as amended from time to time, and adopted by reference.
(c) Laboratory services provided by a family planning clinic will be reimbursed in accordance with the Medicare fee schedule.
(d) Family planning services provided by a health care provider other than a family planning clinic will be reimbursed in accordance with the applicable reimbursement methodology in this chapter for that provider.
History: Eff. 8/18/79, Register 71; readopt 8/7/96, Register 139; am 2/1/97, Register 141; am 6/26/98, Register 146; am 5/5/99, Register 150
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.830 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.
The reimbursement rates for family planning services calculated under 7 AAC 43.108 appear in Table I-2 of the family planning section of the Alaska Medicaid Provider Billing Manual , which may be obtained by contacting the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
The Medicaid Procedures Guide may be obtained by contacting the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
The United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) may be obtained by contacting the Superintendent of Documents, United States Government Printing Office, Washington, D.C. 20402. A copy of the HCPCS is available for examination at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
On December 10, 1999, as required by AS 44.62.245 and AS 47.05.012 , the department gave notice that the following amended version of material, previously adopted by reference in 7 AAC 43.830, would be in effect on January 1, 2000: the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2000. The amended version may be be reviewed at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska, 99503-7167.
On February 1, 2001, as required by AS 44.62.245 and AS 47.05.012 , the department gave notice that the following amended version of material, previously adopted by reference in 7 AAC 43.830, would be in effect on February 5, 2001: the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2001. The amended version may be reviewed at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska, 99503-7167.
On January 4, 2003, as required by AS 44.62.245 and AS 47.05.012 , the department gave notice that the following amended version of material, previously adopted by reference in 7 AAC 43.830 would be in effect on January 1, 2003: the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2003. The amended version may be reviewed at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska, 99503-7167.
As of Register 165 (April 2003), the regulations attorney made a technical revision under AS 44.62.125 (b)(6) and AS 44.62.245 (d), to 7 AAC 43.830(b) , to set out the full title of the Healthcare Common Procedure Coding System (HCPCS), and to reflect a change in the name in the federal agency that issues the document, from the Healthcare Financing Administration (HCFA) to the Centers for Medicare and Medicaid Services (CMS).
On December 5, 2003, as required by AS 44.62.245 and AS 47.05.012 , the department gave notice that the following amended version of material, previously adopted by reference in 7 AAC 43.830, would be in effect on January 1, 2004: the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2004. The amended version may be reviewed at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage Alaska, 99503-7167.
On December 1, 2004, as required by AS 44.62.245 and AS 47.05.012 , the department gave notice that the following amended version of material, previously adopted by reference in 7 AAC 43.830, would be in effect on January 1, 2005: the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2005. The amended version may be reviewed at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
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Last modified 7/05/2006