MedicaidBilling CodesHigh impact
Cost of Care Amount (CoCA) Billing Instructions: ALH and SNF Providers - Revised
Alaska Medicaid·AK · Geriatrics, General Practice·Billing & Coding
Effective date
Aug 2, 2023
We identified it
Jun 21, 2026
Summary
Medicaid waiver providers billing for assisted living and nursing home services must NOT deduct Cost of Care Amount (CoCA) from total charges on claims or enter CoCA in patient payment fields. CoCA will be automatically deducted by Medicaid and shown as Patient Liability on remittance advice.
Action Required
Immediately: Billing team must update procedures for Medicaid waiver claims. For CMS-1500 forms, enter total charge in field 28 without deducting CoCA and do NOT enter CoCA in field 29. For UB-04 forms, enter total charge in field 47 without deducting CoCA and do NOT enter CoCA in fields 48 or 54. For electronic claims, do NOT report CoCA in Loop 2300 AMT segment with F5 qualifier. Failure to follow these instructions will result in underpayment of claims.