Alaska Medicaid fee schedules for 2026 use rates from 2025. Most rates extend through mid-2026. No new statewide physician fee schedule started January 1, 2026.
The Alaska Department of Health publishes specific rates for hospitals, nursing facilities, FQHCs, and surgical centers. These rates cover periods into 2026.
Quick Summary:
- Alaska rates are higher than Lower 48 states
- Hospital inpatient rates: $5,208 per day average
- Outpatient visit rates: $1,233 per visit
- DMEPOS rates increased 2% for 2026
- Physician fees align with Medicare 2026 updates
- Income limit for individuals: $2,296/month
Current Status of 2026 Fee Schedules
No statewide Alaska Medicaid physician fee schedule took effect on January 1, 2026.
The Department of Labor and DHSS continue regulatory work. New rates may be adopted after the January 8-9, 2026 meetings.
Hospital and facility rates from late 2025 documents cover the 2026 period. Many rates are valid from July 1, 2025 through June 30, 2026.
Behavioral health rates saw a 4.5% increase in late 2024. No new 2026-wide adjustments are confirmed yet.
Alaska vs. Lower 48 Rate Comparison
Alaska Medicaid pays significantly more than other states. This accounts for Alaska’s unique healthcare delivery costs.
| Service Category | Alaska Rate (2026) | Lower 48 Rate (2026) |
|---|---|---|
| Inpatient Hospital (Per Day) | $5,208 | $5,707 |
| Outpatient (Per Visit) | $1,233 | $733 |
| Medicare Part B Ancillary | $1,617 | $1,289 |
Alaska outpatient rates are nearly 70% higher than the Lower 48.
Provider Rates by Facility Type
Federally Qualified Health Centers (FQHC)
FQHC rates are set per visit. Rates vary by location and facility.
| FQHC Facility | Rate (USD) | Timeframe |
|---|---|---|
| Anchorage Neighborhood Health | $503.52 | 07/01/2025–06/30/2026 |
| Kodiak Community Health Clinic | $568.93 | 01/01/2025–12/31/2025 |
| Bethel Family Clinic | $1,063.19 | 01/01/2025–12/31/2025 |
Bethel rates are highest due to remote location costs.
Nursing Facilities
Nursing facility rates are paid per day. Rates cover room, board, and basic care.
| Facility | Location | Per Day Rate | Timeframe |
|---|---|---|---|
| Providence Extended Care | Anchorage | $785.96 | 01/01/2025–02/28/2025 |
| Polaris Transitional Care Center | Anchorage | $1,066.45 | 03/01/2025–12/31/2025 |
| Sitka Long-Term Care (SEARHC) | Sitka | $1,316.02 | 10/01/2025–09/30/2026 |
Remote facilities receive higher reimbursement rates.
Ambulatory Surgical Centers
Surgical centers use a group-based rate system. Seven groups exist based on procedure complexity.
| Group | Rate (USD) | Timeframe |
|---|---|---|
| Group 1 | $758.37 | 07/01/2025–06/30/2026 |
| Group 7 | $2,338.28 | 07/01/2025–06/30/2026 |
Group 7 covers the most complex surgical procedures.
Swing Beds
Swing beds provide flexible care between acute and long-term needs.
Statewide Rate: $920.31 per day (01/01/2025–12/31/2025)
ICF/IID Out-of-State Facilities
Some Alaska residents receive care in out-of-state facilities.
Example: ResCare California Inc. – $889.44 per day (07/01/2025–06/30/2026)
Hospital Reimbursement Rates
Alaska hospitals receive per-day inpatient rates and percentage-based outpatient rates.
| Hospital | Location | Inpatient (Per Day) | Outpatient % | Long-Term Care (Per Day) | Timeframe |
|---|---|---|---|---|---|
| PeaceHealth Ketchikan | Ketchikan | $7,080.09 | 44.97% | $1,557.43 | 07/01/2025–06/30/2026 |
| South Peninsula Hospital | Homer | $7,127.88 | 39.88% | $1,573.39 | 07/01/2025–06/30/2026 |
| Wrangell Medical Center | Wrangell | $14,501.35 | 97.26% | $1,507.29 | 10/01/2025–09/30/2026 |
Wrangell Medical Center has the highest rates due to its critical access designation and remote location.
Physician Fee Schedule 2026
Professional fees for 2026 follow the Medicare Physician Fee Schedule (PFS). The 2026 conversion factor is approximately $33.57.
Anesthesia Services
| CPT Code | Non-Facility Rate | Service Description |
|---|---|---|
| 00100 | $290.32 | Anesthesia (Head) |
| 00102 | $348.38 | Anesthesia (Plastic Repair) |
| 00162 | $406.45 | Anesthesia (Nose/Sinus) |
| 00210 | $638.74 | Anesthesia (Intracranial) |
Anesthesia rates increase with procedure complexity and risk.
Detailed physician fee schedules are not yet finalized for 2026. Rates align closely with Medicare’s CY 2026 updates.
For questions about applying for Alaska Medicaid coverage, see the Alaska Medicaid application guide how to apply.
Durable Medical Equipment (DMEPOS) Updates
DMEPOS equipment includes wheelchairs, oxygen, and home medical supplies.
2026 Changes
Net Update Factor: 2% increase for CY 2026
This comes from:
- 2.7% CPI-U inflation increase
- Minus 0.7% productivity adjustment
Jurisdiction: Noridian Medicare administers Alaska DMEPOS claims as Jurisdiction F.
The 2026 DMEPOS jurisdiction list defines which codes Noridian handles for Alaska providers.
Eligibility and Income Limits
Alaska expanded Medicaid under the Affordable Care Act. Coverage extends to 138% of the Federal Poverty Level (FPL).
2026 Income Limits
Individual: $2,296 per month
Family of 4: $4,744 per month
These limits apply to most adult Medicaid categories. Learn more about Alaska Medicaid eligibility 2026 requirements.
What’s Covered
Dental Coverage: Comprehensive for adults over 21
- Exams and cleanings
- X-rays
- Restorative services
Medical Services:
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health services
For income threshold details, visit Alaska Medicaid income limits 2026.
How Providers Submit Claims
Electronic Submission: Health Enterprise Portal (primary method)
Batch Submission: HIPAA-compliant EDI transactions
Paper Claims: Accepted but discouraged (slower processing)
Providers must enroll in Alaska Medicaid before submitting claims. Enrollment takes 30-60 days.
Official Provider Resources
Access the most current information from these official sources:
Alaska Department of Health – Office of Rate Review
https://health.alaska.gov/
Full rate schedules published in PDF format (October 2025)
Medicaid Alaska – Provider Portal
https://www.medicaidalaska.com
Provider manuals, billing guides, and claim forms
Noridian Medicare – Jurisdiction F
Cross-over claims and DMEPOS fee tables for Alaska
Alaska Division of Public Assistance
Eligibility updates and policy information
Monitor these sites for updates following January 2026 regulatory meetings.
Frequently Asked Questions (FAQs)
What is the Alaska Medicaid reimbursement rate for 2026?
Alaska rates vary by service type. Hospital inpatient averages $5,208 per day. Outpatient visits average $1,233. Physician fees follow Medicare’s 2026 conversion factor of $33.57 per relative value unit.
Are Alaska Medicaid rates higher than other states?
Yes. Alaska outpatient rates are 70% higher than Lower 48 states. This reflects Alaska’s remote geography, limited provider availability, and higher operational costs for healthcare facilities.
When will Alaska release the final 2026 physician fee schedule?
No official release date is confirmed. The Department of Health held regulatory meetings January 8-9, 2026. Final schedules may be adopted afterward. Check https://health.alaska.gov/ for updates.
How much did DMEPOS rates increase for 2026?
DMEPOS rates increased 2% net for CY 2026. This reflects a 2.7% inflation adjustment minus a 0.7% Medicare productivity reduction mandated by federal law.
What income qualifies for Alaska Medicaid in 2026?
Individuals earning up to $2,296 per month qualify. Families of four earning up to $4,744 monthly are eligible. Alaska covers adults up to 138% of federal poverty level.
Where do Alaska providers submit Medicaid claims?
Use the Health Enterprise Portal at https://www.medicaidalaska.com for electronic claims. Providers can also submit HIPAA-compliant batch files. Paper claims are accepted but process slower.
Last Updated: January, 2026
Sources: Alaska Department of Health Office of Rate Review, Alaska Division of Public Assistance, Centers for Medicare & Medicaid Services (CMS), Noridian Medicare Jurisdiction F
