Back to dashboard
MedicaidPrior AuthHigh impact

Introduction to Program Change - Therapy

Alaska Medicaid·AK · Physical Therapy, Occupational Therapy, Speech Therapy·Program Update
Effective date
Jul 1, 2023
We identified it
Jun 21, 2026
Days to comply

Summary

Alaska Medicaid is implementing new prior authorization requirements for therapy services (PT, OT, and SLP) for members 21 and older, effective July 1, 2023, with specific unit limits per fiscal year. Additionally, habilitation services will be covered for all ages starting March 3, 2023, and treatment plan requirements have been updated.

Action Required

Action needed
By July 1, 2023: Billing team must implement prior authorization tracking system for Alaska Medicaid therapy services for members 21+ with unit limits: 2 PT/OT evaluations, 30 PT/OT therapy units, 8 SLP evaluations, 15 SLP therapy units per fiscal year. Update billing software to flag when limits are reached. Train staff on new habilitation service coverage and updated treatment plan requirements (6-week intervals vs 4-week for members 21+).

Affected Billing Codes

97161
97162
97163
97164
97165
97166
97167
97168
92526
97010
97012
97014
97016
97018
97022
97024
97026
97028
97032
97033
97034
97035
97036
97039
97110
97112
97113
97116
97124
97129
97130
97139
97140
97150
97530
97533
97535
97537
97542
97799
92521
92522
92523
92524
92507
92508
92606
92609
92630
92633