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(a) The department may enroll as a Medicaid provider of speech-language pathology services
(1) a speech-langauge pathologist who
(A) is licensed under AS 08.11; and
(B) is practicing individually or in a group; and
(2) an outpatient speech therapy center with a current certification from the health facilities licensing and certification section of the division.
(b) The division will directly reimburse a provider of speech-language pathology services for evaluations and the services, materials, and supplies that are ordered by a physician, advanced nurse practitioner, or other licensed health care practitioner who may prescribe the services as within the scope of the practitioner's license and specified in a written treatment plan only if those evaluations, services, materials, and supplies are provided to eligible recipients.
(c) The division will reimburse in-state speech-language pathology services 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. 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 speech-language pathologist for procedures identified the January 1999 version of the Medicaid Procedures Guide . The January 1999 version of the Medicaid Procedures Guide is adopted by reference. The descriptions and billing codes for these procedures 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.
(d) Repealed 12/2/2005.
(e) Repealed 10/12/97.
History: Eff. 9/1/94, Register 131; am 2/1/97, Register 141; am 10/12/97, Register 144; am 6/26/98, Register 146; am 5/5/99, Register 150; am 6/24/2004, Register 170; am 9/29/2005, Register 175; am 12/2/2005, Register 176
Authority: AS 47.05.010
Editor's note: The reimbursement rates for speech-language pathology services calculated under 7 AAC 43.108 appear in Table I-3 of the physical/speech therapist service and Table I-5 of the certified speech pathologist 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 43.926, 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 43.926, 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 43.926, 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 43.926(c) , 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 43.926, 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 43.926, 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