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Cost of Care Amount (CoCA) Billing Instructions - Revised

Alaska Medicaid·AK·Billing & Coding
Effective date
Aug 2, 2023
We identified it
Jun 21, 2026
Days to comply

Summary

Alaska Medicaid has updated billing instructions for Cost of Care Amount (CoCA) for waiver recipients not receiving residential supported living or nursing home services. Providers must reduce their CMS-1500 claims by the amount they collect directly from recipients as cost of care payments, entering the total service charge in field 28 and the cost of care amount collected in field 29.

Action Required

Action needed
Immediately: Billing team must update CMS-1500 claim submission procedures for Alaska Medicaid waiver recipients. Enter total service charges in field 28 and any cost of care amounts collected from recipients in field 29. Reduce total claim amount by cost of care collected before submitting to Medicaid. Train staff on identifying recipients subject to cost of care liability and proper claim reduction procedures.

Affected Billing Codes

T2031