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(a) For payment under Medicaid, a chiropractor
(1) must be licensed by the Alaska Board of Chiropractic Examiners;
(2) must meet the federal standards established for Medicare at 42 C.F.R. 405.232(b); and
(3) shall comply with the requirements of 18 AAC 85.
(b) The division will reimburse an enrolled chiropractor for the procedures identified in 7 AAC 43.920. The division will calculate maximum allowable rates for covered services by using the factors and formula described in 7 AAC 43.108. Medicaid payment for chiropractic services is limited to recipients under age 21 and is subject to the following payment limitations:
(1) services not described in 7 AAC 43.920, including examinations, consultations, supplies, and x-rays, are not covered services;
(2) reimbursement will be made for no more than 12 visits in a calendar year for a recipient;
(3) reimbursement will be made for no more than one division-assigned chiropractic x-ray billing code during a calendar year for a recipient;
(4) reimbursement for a treatment consisting of manual manipulation to correct a subluxation of the spine will be in accordance with 7 AAC 43.040;
(5) reimbursement for x-rays necessary for diagnosis of subluxation of the spine will be in accordance with 7 AAC 43.040; and
(6) chiropractic services for children under six years of age must have prior authorization from the division.
(c) Notwithstanding the provisions of this section and of 7 AAC 43.920, no Medicaid payment will be made for chiropractic services provided at any time after July 5, 1989, and before July 1, 1990.
History: Eff. 11/6/86, Register 100; am 7/5/89, Register 111; em am 8/1/92 - 11/28/92, Register 123; am 11/18/93, Register 128; am 9/1/94, Register 131; 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: The reimbursement rates for chiropractic services calculated under 7 AAC 43.108 appear in Table I-3 of the chiropractic services section of the Alaska Medicaid Provider Billing Manual, which may be obtained by contacting the Department of Health and Social Services, Division of Medical Assistance, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
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Last modified 7/05/2006