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May 2025 Town Hall Presentation

Alaska Medicaid·AK·Program Update
Effective date
May 21, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Alaska Medicaid has updated Third Party Liability (TPL) requirements for EDI claims, requiring specific documentation and coding segments when primary insurance doesn't pay all lines. New streamlined telehealth fee schedule has been implemented with changes to audio-only service billing codes.

Action Required

Action needed
Immediately: Update EDI claim submission process to include required TPL segments (PWK, CAS loops) when primary insurance doesn't pay all lines or for all dental claims. Enter 'EB' indicator in PWK segment and 'AA' in PWK02 field when EOB received. Review new telehealth fee schedule for removed codes and replacement billing methods for audio-only services. Claims will suspend up to 14 days without proper TPL documentation.