Medicaid State Plan Amendment – Updates to Fee Schedule Effective Dates and Links

Agency Action: Amendment to the Medicaid State PlanThe Department of Health (the department) hereby gives notice that it intends to seek approval from the Centers for Medicare and Medicaid Services (CMS) for a state plan amendment (SPA), with a July 1, 2025, effective date. Subject of Amendment(s): The purpose of the proposed SPA is to update the effective date, links to rate schedules (when applicable), and align language with rate description for the following fee schedules in state plan section 4.19-B. The changes are not reflective of changes to rate methods or standards. A. Ambulatory Surgical Clinic Services The change reflects a description of the annual inflationary adjustment of 3.1%, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $134,230 for federal funds and $64,173 for state funds.B. In-home Peritoneal Services The change reflects an update to the fee schedule link, rebasing rate adjustment, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $9,741 for federal funds and $5,673 for state funds. Licensed Behavior Analysts The change reflects the updated Medicare rate and revised conversion factor of 3.2%, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $68,150 for federal funds and $64,435 for state funds. Physician services This change reflects a description of the annual inflationary adjustment, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY 2026 of $3,745,833 for federal funds and $1,248,611 for state funds. E. Advanced Practice Dental Hygienist The change reflects a description of the annual inflationary adjustment, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). No estimated increase in costs for SFY2026. F. Personal Care Services The change reflects a description of the annual inflationary adjustment of 3.2%, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $437,459 federal funds and $393,452 state funds.G. Personal Care Services for Community First Choice Option The change reflects a description of the annual inflationary adjustment of 3.2%, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $496,736 federal funds and $312,070 state funds.H. Chore Services for Community First Choice Option The change reflects a description of the annual inflationary adjustment, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $16,136 federal funds and $8,125 state funds.I. Long Term Services and Supports (LTSS) Targeted Case Management The change reflects a description of the annual inflationary adjustment of 3.2%, an update to the fee schedule link, and updated language describing the methodology in accordance with CMS requirements (listing the formula for rate setting via description of base rate and inflation factor). This results in an estimated increase in costs for SFY2026 of $86,528 federal funds and $50,224 state funds.J. Substance Use Rehabilitation Services (Combined with Mental Health Clinic)1. This change reflects the updated Medicare rate and revised conversion factor of 3.2% and the service is updated to list the link to fee schedules within the document rather than each service. 2. This results in an estimated increase in costs for SFY2026 of $956,740 for federal funds and $548,297 for state funds. K. Services not listed above, but described in pages 1, 1.1, 1.2, 1.2a, 1b, 3, 4, 5b, 6, 9, 11, 11a.2, 11b, & 12 1. Services that are not listed above will have technical changes to update the link to the fee schedules and does not reflect a change in methodology.EPSDT and ARRAThe proposed amendments will not affect how Alaska Medicaid provides or reimburses Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. Public Comments:The department is holding a public comment period relative to these amendments until 5 PM on September 11, 2025. Individuals may submit written comments via email to christal.hays@alaska.gov. Please submit electronic comments as an attached word document or text within the email body with the phrase “2025 Fee Schedule Updates” in the subject line. All submissions must include the sender’s full name and email address.If you are a person with a disability who requires a special accommodation to participate in this process, please contact Christal Hays christal.hays@alaska.gov or (907)891-4830 not later than August 28, 2025, to ensure the provision of any necessary accommodations.Individuals unable to submit comments by email should submit written comments by the close of the comment period to:DOH Commissioner’s Officec/o Christal Hays3601 C Street, Suite 902Anchorage, AK 99503