Alaska

At A Glance
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MEDICAID REIMBURSEMENT

  • Live Video: Yes
  • Store-and-Forward: Yes
  • Remote Patient Monitoring: Yes
  • Audio Only: Yes

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: No

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: None
  • Consent Requirements: Yes

STATE RESOURCES

  1. Medicaid Program: Alaska Medicaid
  2. Administrator: Alaska Dept. of Health and Social Services, Division of Public Assistance
  3. Regional Telehealth Resource Center: Northwest Regional Telehealth Resource Center

Last updated 08/15/2022

Audio Only Delivery

Division of Behavioral Health:  Telemedicine Emergency Response Policy Guidance

STATUS: Active, until providers notified

Division of Behavioral Health: FQ Modifier

STATUS:  Active during federal PHE, scheduled to end Oct. 13, 2022.  Document indicates will issue guidance if PHE extended beyond July 15, 2022. No guidance has yet been issued.

Medicaid: PHE Declaration

STATUS: Active, until rescinded or federal PHE expires

Last updated 08/15/2022

Cross State Licensing

Medicaid: Telehealth Coverage COVID-19 FAQs

STATUS: Active, though license waivers have expired.

Business and Professional Licensing: Telehealth and Licensing

STATUS: Expired, however licensing exception during public health emergency extended permanently by SB 241.

Office of the Governor: Six-Month Window to submit continue working with the State Medical Board and submit for permanent licensure.

STATUS: Expires Nov. 3, 2022

Last updated 08/15/2022

Easing Prescribing Requirements

STATUS: Varies, some expiration dates vary.

Professional Regulation: State Emergency Regulations made permanent

STATUS: Permanent

Professional Regulation: Opioid Treatment by APRNs During Emergencies Made Permanent

STATUS: Permanent

SB 241: In-Person Exam Requirement

STATUS: Enacted

State Nursing Board: Standards of Practice for Telehealth

STATUS: Permanent

Alaska Department of Commerce, Community, and Economic Development: Telehealth and Licensing During COVID-19

STATUS: Temporary allowances expired.  Document also outlines permanent policies.

Last updated 08/15/2022

Miscellaneous

Division of Corporations, Business and Professional Licensing: Telemedicine Business Registry

STATUS: Parts have expired, while others are still active

Last updated 08/15/2022

Originating Site

Medicaid: Telehealth Coverage COVID-19 FAQs

STATUS: Active

Medicaid: Temporary Expansion of Medicaid Telehealth Services

STATUS: Active

Last updated 08/15/2022

Private Payer

Alaska Department of Commerce, Community, and Economic Development: Telehealth and Licensing During Covid-19

STATUS: Parts have expired while other sections are still active.

Alaska Remittance Advice Message: Medicaid Telehealth Coverage

STATUS: Active until the DHSS’ PHE is rescinded, or the federal PHE ends, whichever comes first. 

Department of Commerce, Community, and Economic Development: Coverage of Telehealth

STATUS: Active, communicates permanent policy.

Last updated 08/15/2022

Provider Type

Medicaid: DHSS PHE Declaration

STATUS: Active, until rescinded or federal PHE expires

Last updated 08/15/2022

Service Expansion

Medicaid: Telehealth Fee Schedule

STATUS: Active, until national PHE ends

Medicaid: PHE Declaration

STATUS: Active, until rescinded or federal PHE expires

Last updated 08/15/2022

Definitions

“Telehealth” means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of health care data through audio, visual, or data communications, performed over two or more locations between providers who are physically separated from the recipient or from each other or between a provider and a recipient who are physically separated from each other.

SOURCE: AK Statute Sec. 47.05.270(e), (Accessed Aug. 2022).

Last updated 08/15/2022

Parity

SERVICE PARITY

Health care insurers shall provide coverage for benefits provided through telehealth by a health care provider and may not require that prior in-person contact between a health care provider and a patient before payment is made for covered services.

SOURCE: AK Statute, Sec. 21.42.422 (Accessed Aug. 2022).


PAYMENT PARITY

No Reference Found

 

Last updated 08/15/2022

Requirements

A health care insurer that offers, issues for delivery, or renews in the state a health care insurance plan in the group or individual market shall provide coverage for benefits provided through telehealth by a health care provider licensed in this state and may not require that prior in-person contact between a health care provider and a patient before payment is made for covered services.

SOURCE: AK Statute, Sec. 21.42.422 (Accessed Aug. 2022)

Last updated 08/15/2022

Definitions

“telehealth” means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of health care data through audio, visual, or data communications, performed over two or more locations between providers who are physically separated from the recipient or from each other or between a provider and a recipient who are physically separated from each other.

SOURCE: AK Statute Sec. 47.05.270(e), (Accessed Aug. 2022).

“Alaska Medicaid will pay for telemedicine services delivered in the following manner:

  • Interactive method: Provider and patient interact in ‘real-time’ using video/camera and/or dedicated audio conference equipment.
  • Store-and-forward method: The provider sends digital images, sounds, or previously recorded video to a consulting provider at a different location. The consulting provider reviews the information and reports back his or her analysis.
  • Self-monitoring method: The patient is monitored in his or her home via a telemedicine application, with the provider indirectly involved from another location.”

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Physician Services (5/2013); Physician Mental Health Physician Clinic (1/2/2019) (Accessed Aug. 2022).

The department will pay a provider for a telemedicine application if the provider provided the medical services through one of the following methods of delivery in the specified manner:

  • Live or interactive: the service must be provided through the use of camera, video, or dedicated audio conference equipment on a real-time basis; medical services provided by a telephone that is not a part of a dedicated audio conference system or by a facsimile machine are not eligible for payment under this paragraph
  • Store-and-forward: the service must be provided through the transference of digital images, sounds, or previously recorded video from one location to another to allow a consulting provider to obtain information, analyze it, and report back to the referring provider
  • Self-monitoring or testing: the services must be provided by a telemedicine application based in the recipient’s home, with the provider only indirectly involved in the provision of the service.

SOURCE: AK Admin. Code, Title 7, 110.625 & Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).

Telemedicine means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of medical data through audio, video, or data communications that are performed over two or more locations between providers who are physically separated from the recipient or from each other.

SOURCE: AK Admin. Code, Title 7, 12.449; 12.49086.090 & Sec. 110.639 (Accessed Aug. 2022).

Telehealth means practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of medical data, audio, visual, or data communications that are performed over two or more locations between providers who are physically separated from the recipient or from each other.

SOURCE:  Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022 (Accessed Aug. 2022).

Last updated 08/15/2022

Email, Phone & Fax

The department shall pay for all services covered by the medical assistance program provided through telehealth if the department pays for those services when provided in person, including …

  • services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.07.069, (Accessed Aug. 2022).

Live or interactive; to be eligible for payment under this paragraph, the service must be provided through the use of camera, video, or dedicated audio conference equipment on a real-time basis; medical services provided by a telephone that is not part of a dedicated audio conference system or by a facsimile machine are not eligible for payment.

Audio only mode: Add modifier FQ for dates of service on or after 3/1/2022.

SOURCE:  Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).

No reimbursement for telephone when not part of a dedicated audio conference system.

No reimbursement for FAX.

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); Physician, ARNP and PA Services (5/13), & AK Admin Code, Title 7, 110.625 & 635 (Accessed Aug. 2022).

Last updated 06/02/2022

Live Video

POLICY

The department shall pay for all services covered by the medical assistance program provided through telehealth if the department pays for those services when provided in person (see Eligible Services Section below for eligible services).

The department shall adopt regulations for services provided by telehealth, including setting rates of payment. The department may set a rate of payment for a services provided through telehealth that is different from the rate of payment for the same service provided in person.  The department may exclude or limit coverage or reimbursement for a service provided by telehealth, or limit the telehealth modes that may be used for a particular service, only if the department

  1. specifically excludes or limits the service from telehealth coverage or reimbursement by regulations adopted under this subsection;
  2. determines, based on substantial medical evidence, that the service cannot be safely provided using telehealth or using the specified mode; or
  3. determines that providing the service using the specified mode would violate federal law or render the service ineligible for federal financial participation under applicable federal law.

All services delivered through telehealth under this section must comply with the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191).

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.07.069, (Accessed Aug. 2022).

Alaska’s Medicaid program will reimburse for services “provided through the use of camera, video, or dedicated audio conference equipment on a real-time basis.”

SOURCE: AK Admin. Code, Title 7, 110.625(a)(1). (Accessed Aug. 2022).

Alaska Medicaid will pay for a covered medical service furnished through telemedicine application if the service is:

  • Covered under traditional, non-telemedicine methods;
  • Provided by a treating, consulting, presenting or referring provider;
  • Appropriate for provision via telemedicine

Source: State of AK Dept. of Health and Social Svcs, Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); Physician, PA, ARNP Services (5/13). (Accessed Aug. 2022).

The department will pay for telemedicine applications provided by a treating, consulting, presenting, or referring provider for a medical service covered by Medicaid and provided within the scope of the provider’s license. A presenting provider is only eligible to receive Medicaid payment for a live or interactive telemedicine application.

SOURCE: AK Admin. Code, Title 7, 110.630. (Accessed Aug. 2022).

The department will pay for medical services furnished through telemedicine applications as an alternative to traditional methods of delivering services to Medicaid recipients. For the provider to receive payment, the provider’s use of telemedicine applications must comply with the standards for services delivered under the Medicaid program and for the medical services provided by the type of provider, including provisions that affect the efficiency, economy and quality of service; and coverage limitations.

SOURCE:  Alaska Admin Code. Title 7, Sec. 110.620. (Accessed Aug. 2022).

The department will pay a provider for a telemedicine application if the provider provided the medical services through one of the following methods of delivery in the specified manner:

  • Live or interactive: the service must be provided through the use of camera, video, or dedicated audio conference equipment on a real-time basis; medical services provided by a telephone that is not a part of a dedicated audio conference system or by a facsimile machine are not eligible for payment under this paragraph
  • Store-and-forward: the service must be provided through the transference of digital images, sounds, or previously recorded video from one location to another to allow a consulting provider to obtain information, analyze it, and report back to the referring provider
  • Self-monitoring or testing: the services must be provided by a telemedicine application based in the recipient’s home, with the provider only indirectly involved in the provision of the service.

SOURCE: AK Admin. Code, Title 7, 110.625 & Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).


ELIGIBLE SERVICES/SPECIALTIES

The department shall pay for all services covered by the medical assistance program provided through telehealth if the department pays for those services when provided in person, including:

  1. behavioral health services;
  2. services covered under home and community-based waivers;
  3. services covered under state plan options under 42 U.S.C. 1396-1396p (Title XIX, Social Security Act);
  4. services provided by a community health aide or a community health practitioner certified by the Community Health Aide Program Certification Board;
  5. services provided by a behavioral health aide or behavioral health practitioner certified by the Community Health Aide Program Certification Board;
  6. services provided by a dental health aide therapist certified by the Community Health Aide Program Certification Board;
  7. services provided by a chemical dependency counselor certified by a certifying entity for behavioral health professionals in the state specified by the department in regulation;
  8. services provided by a rural health clinic or a federally qualified health center;
  9. services provided by an individual or entity that is required by statute or regulation to be licensed or certified by the department or that is eligible to receive payments, in whole or in part, from the department;
  10. services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio;
  11. assessment, evaluation, consultation, planning, diagnosis, treatment, case management, and the prescription, dispensing, and administration of medications, including controlled substances; and
  12. services covered under federal waivers or demonstrations other than home and community-based waivers.

The department shall adopt regulations for services provided by telehealth, including setting rates of payment. The department may set a rate of payment for a services provided through telehealth that is different from the rate of payment for the same service provided in person.  The department may exclude or limit coverage or reimbursement for a service provided by telehealth, or limit the telehealth modes that may be used for a particular service, only if the department

  1. specifically excludes or limits the service from telehealth coverage or reimbursement by regulations adopted under this subsection;
  2. determines, based on substantial medical evidence, that the service cannot be safely provided using telehealth or using the specified mode; or
  3. determines that providing the service using the specified mode would violate federal law or render the service ineligible for federal financial participation under applicable federal law.

All services delivered through telehealth under this section must comply with the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191).

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.07.069, (Accessed Aug. 2022).

Medically necessary office consultations provided via telemedicine may be covered only when used as a second opinion and the provider is of a different specialty than the requesting provider.  Documentation requirements apply.

SOURCE: Alaska Medicaid Policy Clarification: Office Consultations via Telemedicine Applications.  March 30, 2017. (Accessed Dec. 2021)Alaska Medicaid Policy Clarification; Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022)

Eligible services:

  • Initial or one follow-up office visit;
  • Consultation made to confirm diagnosis;
  • A diagnostic, therapeutic or interpretive service;
  • Psychiatric or substance abuse assessments;
  • Psychotherapy; or
  • Pharmacological management services on an individual recipient basis.

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); & Physician, ARNP, PA Services (5/13) & Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022 (Accessed Aug. 2022).

Family psychotherapy may be provided through telemedicine, with or without recipient involvement, if the services could not be provided in person and the clinician documents the reason for providing the service telephonically in the recipient’s treatment notes for each session.

SOURCE: AK Dept. of Health and Social Svcs. Billing for Telemedicine Services. Community Behavioral Health Clinic Services; Mental Health Physician Clinic (1/2/19). (Accessed Aug.. 2022).

The GT or 95 modifier should be used to indicate live interactive mode. Use place of service 10 if member is in their home during the telehealth visit and 02 if member is at any
other location.

SOURCE: Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).

Dental services do not require the use of the telemedicine modifier.

SOURCE: AK Dept. of Health and Social Svcs.  Dental Services.  Tribal Services Manual (1/3/17).  (Accessed Aug. 2022).

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

SOURCE:  AK Admin. Code, Title 7, 110.635 (Accessed Jun. 2022).

Alaska Medicaid will not pay for

  • The use of telemedicine equipment and systems
  • Services delivered by telephone when not part of a dedicated audio conference system
  • Services delivered by fax

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); Physician, ARNP and PA Services (5/13) (Aug. 2022).

No reimbursement for:

  • Direct entry midwife
  • Durable medical equipment (DME)
  • End-stage renal disease
  • Home and community-based waiver
  • Personal care assistant
  • Pharmacy
  • Private duty nursing
  • Transportation and accommodation
  • Vision (includes visual care, dispensing, or optician services)

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); Physician, ARNP and PA Services (5/13), & AK Admin. Code, Title 7, 110.635 & Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).

The department will pay for a service rendered by a consulting or referring provider by a telemedicine application. Payment to the presenting provider is limited to the rate established for brief evaluation and management of an established patient.  The department will pay the receiving provider in the same manner as payment is made for the same service provided through traditional mode of delivery, not to exceed 100 percent of the rate established under 7 AAC 145.050.

SOURCE: AK Admin Code, Title 7, 145.270, (Accessed Aug. 2022).

The department will not pay a physician for experimental therapy, nonmedical outpatient therapy, or nonmedical counseling, including any of the following services:

  • interaction between recipient and provider by means of the Internet, except as provided in 7 AAC 110.620 — 7 AAC 110.639 for telemedicine services.

SOURCE: Alaska Admin Code, Title 7, 110.445, (Accessed Aug. 2022).


ELIGIBLE PROVIDERS

The department shall pay for all services covered by the medical assistance program provided through telehealth if the department pays for those services when provided in person, including:

  1. services provided by a community health aide or a community health practitioner certified by the Community Health Aide Program Certification Board;
  2. services provided by a behavioral health aide or behavioral health practitioner certified by the Community Health Aide Program Certification Board;
  3. services provided by a dental health aide therapist certified by the Community Health Aide Program Certification Board;
  4. services provided by a chemical dependency counselor certified by a certifying entity for behavioral health professionals in the state specified by the department in regulation;
  5. services provided by a rural health clinic or a federally qualified health center;
  6. services provided by an individual or entity that is required by statute or regulation to be licensed or certified by the department or that is eligible to receive payments, in whole or in part, from the department;

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.07.069, (Accessed Aug. 2022).

Providers fall into three categories:

  1. Referring Provider: Evaluates a patient, determines the need for a consultation, and arranges services of a consulting provider for the purpose of diagnosis and treatment.
  2. Presenting Provider: Introduces a patient to the consulting provider during an interactive telemedicine session (may assist in the telemedicine consultation).
  3. Consulting Provider: Evaluates the patient and/or medical data/images using telemedicine mode of delivery upon recommendation of the referring provider.

SOURCE: AK Dept. of Health and Social Svcs. Billing for Telemedicine Services. Audiology  Services (6/12); Autism Services (6/12); Chiropractic Services (6/12)Community Behavioral Health Clinic Services (6/12); Direct-Entry Midwives Services (6/12); EPSDT (6/12); Family Planning (6/12); FQHC/RHC (6/12); Imaging Services (6/12); Independent Laboratory (6/12); Mental Health Physician Clinic (6/12); Nutrition (6/12); Physician (6/12); Private Duty Nursing (6/12); Psychologist (6/12); Podiatry (6/12); School-Based Services (6/12); Residential Behavioral Rehabilitation Services (6/12); Therapies (6/12); Vision (6/12) & Alaska Admin Code Title 7, Sec. 110.639. (Accessed Aug. 2022).

Office consultations performed by a provider of the same specialty within the same organization are not covered.

SOURCE: Alaska Medicaid Policy Clarification: Office Consultations via Telemedicine Applications.  March 30, 2017. (Accessed Aug. 2022).

Mental Health

An entity designated by the department under AS 47.30.520 – 47.30.620 may provide community mental health services authorized under AS 47.30.520 – 47.30.620 through telehealth to a patient in this state.

If an individual employed by an entity designated by the department under AS 47.30.520 – 47.30.620, in the course of a telehealth encounter with a patient, determines that some or all of the encounter will extend beyond the community mental health services authorized under AS 47.30.520 – 47.30.620, the individual shall advise the patient that the entity is not authorized to provide some or all of the services to the patient, recommend that the patient contact an appropriate provider for the services the entity is not authorized to provide, and limit the encounter to only those services the entity is authorized to provide. The entity may not charge a patient for any portion of an encounter that extends beyond the community mental health services authorized under AS 47.30.520 – 47.30.620.

A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.

An entity permitted to provide telehealth under this section may not be required to document a barrier to an in-person visit to provide health care services through telehealth. The department may not limit the physical setting from which an entity may provide health care services through telehealth.

Nothing in this section requires the use of telehealth when an individual employed by an entity designated by the department under AS 47.30.520 – 47.30.620 determines that providing services through telehealth is not appropriate or when a patient chooses not to receive services through telehealth.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.30.585, (Accessed Aug. 2022).

Uniform Alcoholism and Intoxication Treatment

A public or private treatment facility approved under AS 47.37.140 may provide health care services authorized under AS 47.37.030 – 47.37.270 through telehealth to a patient in this state.

If an individual employed by a public or private treatment facility approved under AS 47.37.140, in the course of a telehealth encounter with a patient, determines that some or all of the encounter will extend beyond the health care services authorized under AS 47.37.030 – 47.37.270, the individual shall advise the patient that the facility is not authorized to provide some or all of the services to the patient, recommend that the patient contact an appropriate provider for the services the facility is not authorized to provide, and limit the encounter to only those services the facility is authorized to provide. The facility may not charge a patient for any portion of an encounter that extends beyond the health care services authorized under AS 47.37.030 – 47.37.270.

A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.

A facility permitted to practice telehealth under this section may not be required to document a barrier to an in-person visit to provide health care services through telehealth. The department may not limit the physical setting from which a facility may provide health care services through telehealth.

Nothing in this section requires the use of telehealth when an individual employed by a facility approved under AS 47.37.140 determines that providing services through telehealth is not appropriate or when a patient chooses not to receive services through telehealth.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.37.145, (Accessed Aug. 2022).


ELIGIBLE SITES

No reference found.


GEOGRAPHIC LIMITS

No reference found.


FACILITY TRANSMISSION FEE

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

SOURCE: AK Admin. Code, Title 7, 110.635(b). (Accessed Aug. 2022)

 

Last updated 08/15/2022

Miscellaneous

Documentation requirements for telemedicine consultations include:

  • Statement that the service was provided using telemedicine
  • The address location of the patient
  • The address location of the provider
  • The method of telemedicine used
  • The names of all persons participating in the telemedicine service and their role in the encounter
  • The inquiry from the requesting provider
  • The consulting provider’s report back to the requesting provider (see policy for more details).

SOURCE: Alaska Medicaid Policy Clarification: Office Consultations via Telemedicine Applications.  March 30, 2017. (Accessed Aug. 2022)

Payment to the presenting provider is limited to the rate established for brief evaluation and management of an established patient.

Receiving providers will be reimbursed in the same manner as reimbursement is made for the same service provided through traditional modes of delivery, not to exceed 100 percent of the rate established in state law.

SOURCE: AK Admin Code, Title 7, 145.270. (Accessed Aug. 2022).

Family psychotherapy may be provided through telemedicine, with or without recipient involvement, if the services could not be provided in person and the clinician documents the reason for providing the service telephonically in the recipient’s treatment notes for each session.

SOURCE: Mental Health Physician Clinic, Psychotherapy (1/2/19) (Accessed Aug. 2022).

Medical Assistance Reform Program

The department shall identify the areas of the state where improvements in access to telehealth would be most effective in reducing the costs of medical assistance and improving access to health care services for medical assistance recipients. The department shall make efforts to improve access to telehealth for recipients in those locations. The department may enter into agreements with Indian Health Service providers, if necessary, to improve access by medical assistance recipients to telehealth facilities and equipment.

SOURCE: Alaska Statute 47.05.270, (Accessed Aug. 2022).

Last updated 08/15/2022

Out of State Providers

No Reference Found

Last updated 08/15/2022

Overview

Alaska reimburses for Live Video, Store & Forward & Remote Patient Monitoring, although some restrictions apply.  Passed legislation and a memo indicates Alaska Medicaid pays for audio-only telehealth, however their policy manuals have not yet been updated with the change.

Last updated 08/15/2022

Remote Patient Monitoring

POLICY

Alaska Medicaid will reimburse for services delivered through self-monitoring, where the patient is monitored in their home via a telemedicine application, with the provider indirectly involved from another location.

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); Physician, ARNP and PA Services (5/13) & Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).

To be eligible for payment under self-monitoring or testing, “the services must be provided by a telemedicine application based in the recipient’s home, with the provider only indirectly involved in the provision of the service.”

SOURCE: AK Admin. Code, Title 7, 110.625(a). (Accessed Aug. 2022).


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 08/15/2022

Store and Forward

POLICY

The department shall pay for all services covered by the medical assistance program provided through telehealth if the department pays for those services when provided in person, including …

  • services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 47.07.069, (Accessed Aug. 2022).

Alaska Medicaid will reimburse for Store & Forward telehealth, which is defined as the “provider sends digital images, sounds, or previously recorded video to a consulting provider at a different location.  The consulting provider reviews the information and reports back his or her analysis.

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services (1/2/19); Mental Health Physician Clinic (1/2/2019); Physician, ARNP and PA Services (5/13), (Accessed Aug. 2022).

The department will pay for medical services furnished through telemedicine applications as an alternative to traditional methods of delivering services to Medicaid recipients. For the provider to receive payment, the provider’s use of telemedicine applications must comply with the standards for services delivered under the Medicaid program and for the medical services provided by the type of provider, including provisions that affect the efficiency, economy and quality of service; and coverage limitations.  Store-and-forward services must be provided through the transference of digital images, sounds, or previously recorded video from one location to another to allow a consulting provider to obtain information, analyze it, and report back to the referring provider.

SOURCE:  Alaska Admin Code. Title 7, Sec. 110.620 & 625. (Accessed Aug. 2022).


ELIGIBLE SERVICES/SPECIALTIES

A consulting provider may send data he/she has received during a store-and-forward telemedicine consultation to another consulting provider (with equal or greater scope of practice as determined by his/her occupational license or level of expertise within their field of specialty).

SOURCE: AK Dept. of Health and Social Svcs. Billing for Telemedicine Services. Audiology Services (6/12); Autism Services (6/12); Chiropractic Services (6/12); Community Behavioral Health Clinic Services (6/12); Direct-Entry Midwives Services (6/12); EPSDT (6/12); Family Planning (6/12); FQHC/RHC (6/12); Imaging Services (6/12); Independent Laboratory (6/12); Mental Health Physician Clinic (6/12); Nutrition (6/12); Physician (6/12); Private Duty Nursing (6/12); Professional Claims Management (6/12): Psychologist (6/12); Podiatry (6/12); School-Based Services (6/12); Residential Behavioral Rehabilitation Services (6/12); Therapies (6/12); Vision (6/12) (Accessed Aug. 2022).

Eligible services:

  • Initial or one follow-up office visit;
  • Consultation made to confirm diagnosis;
  • A diagnostic, therapeutic or interpretive service;
  • Psychiatric or substance abuse assessments;
  • Psychotherapy; or
  • Pharmacological management services on an individual recipient basis.

SOURCE: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services; Mental Health Physician Clinic (1/2/2019); & Physician, ARNP and PA Services (5/13) & Alaska Medicaid Policy Clarification: Medicaid Telehealth Coverage. Mar. 1, 2022. (Accessed Aug. 2022).


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

SOURCE: AK Admin. Code, Title 7, 110.635(b). (Accessed Aug. 2022).

Last updated 08/15/2022

Cross State Licensing

A health care provider licensed in this state may provide health care services within the health care provider’s authorized scope of practice to a patient in this state through telehealth without first conducting an in person visit.

A physician licensed in another state may provide health care services through telehealth to a patient located in the state as provided in this subsection, subject to the investigative and enforcement powers of the department under AS 08.01.087, and subject to disciplinary action by the State Medical Board under AS 08.64.333. The privilege to practice under this subsection extends only to (1) ongoing treatment or follow-up care related to health care services previously provided by the physician to the patient and applies only if

  • the physician and the patient have an established physician patient relationship; and
  • the physician has previously conducted an in-person visit with the patient; or

A visit regarding a suspected or diagnosed life-threatening condition for which

  • the patient has been referred to the physician licensed in another state by a physician licensed in this state and that referral has been documented by the referring physician; and
    the visit involves communication with the patient regarding diagnostic or treatment plan options or analysis of test results for the life threatening condition.

If a health care provider determines in the course of a telehealth encounter with a patient under this section that some or all of the encounter will extend beyond the health care provider’s authorized scope of practice, the health care provider shall advise the patient that the health care provider is not authorized to provide some or all of the services to the patient, recommend that the patient contact an appropriate provider for the services the health care provider is not authorized to provide, and limit the encounter to only those services the health care provider is authorized to provide.  The health care provider may not charge for any portion of an encounter that extends beyond the health care provider’s authorized scope of practice.

A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 08.01.085, (Accessed Aug. 2022).

The board may sanction a physician licensed in another state who provides health care services through telehealth (see statute for list of criteria and repercussions).

SOURCE: AK House Bill 265 (2022 Session) and Sec. 08.64.333, (Accessed Aug. 2022).

Emergency Medical Services

An individual certified or licensed under this chapter may practice within the individual’s authorized scope of practice under this chapter through telehealth with a patient in this state if the individual’s certification or license is in good standing.

If an individual certified or licensed under this chapter determines in the course of a telehealth encounter with a patient that some or all of the encounter will extend beyond the individual’s authorized scope of practice, the individual shall advise the patient that the individual is not authorized to provide some or all of the services to the patient, recommend that the patient contact an appropriate provider for the services the individual is not authorized to provide, and limit the encounter to only those services the individual is authorized to provide. The individual certified or licensed under this chapter may not charge for any portion of an encounter that extends beyond the individual’s authorized scope of practice.

A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.

An individual certified or licensed under this chapter may not be required to document a barrier to an in-person visit to provide health care services through telehealth. The department or the council may not limit the physical setting from which an individual certified or licensed under this chapter may provide health care services through telehealth.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 18.08.100, (Accessed Aug. 2022).

Last updated 08/15/2022

Definitions

“Telehealth” means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of health care data through audio, visual, or data communications, performed over two or more locations between providers who are physically separated from the recipient or from each other or between a provider and a recipient who are physically separated from each other.

SOURCE: AK Statute Sec. 47.05.270(e), (Accessed Aug. 2022).

Business Registry

“Telemedicine services” means the delivery of health care services using the transfer of medical data through audio, visual, or data communications that are performed over two or more locations by a provider who is physically separated from the recipient of the health care services.

SOURCE: AK Statute, Sec. 44.33.381(c) (Accessed Aug. 2022).

Speech-Language Pathology 

“Asynchronous telemedicine” means the capturing and transmitting of data for the later viewing or interpreting by a person licensed or registered under AS 08.11.

SOURCE: AK Admin. Code, Title 12, Sec. 07.090(4). (Accessed Aug. 2022).

Last updated 08/15/2022

Licensure Compacts

No Reference Found

Last updated 08/15/2022

Miscellaneous

A health care provider may not be required to document a barrier to an in10 person visit to provide health care services through telehealth. The department or a board may not limit the physical setting from which a health care provider may provide health care services through telehealth.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 08.01.085, (Accessed Aug. 2022).

The Department of Commerce, Community and Economic Development has adopted regulations for establishing and maintaining a registry of businesses performing telemedicine in the state.  See business registry regulations for more details.

To be registered on the telemedicine business registry established and maintained under AS 44.33.381, and before providing telemedicine services to a recipient located in this state, a business performing telemedicine services must submit to the department:

  • a complete registration on a form provided by the department; the registration must include the business’s name, address, and contact information;
  • a copy of the business’s valid business license issued under AS 43.70 and 12 AAC 12; and
  • the applicable fee established in 12 AAC 02.106.

A business performing telemedicine services must register with the name it is using to perform telemedicine services in this state. A business operating under multiple names to perform telemedicine services shall file a separate registration for each name.

If the name, address, or contact information of a business on the telemedicine business registry changes, the business performing telemedicine services must submit to the department, not later than 30 days after the change or termination:

  • a complete report, on a form provided by the department, of each change; and
  • the applicable fee established in 12 AAC 02.106.

A business that fails to comply timely with (c) of this section may not perform telemedicine services in this state and must submit a new application under (a) of this section before resuming the provision of telemedicine services to a recipient located in this state.

If a business terminates the performance of telemedicine services in this state, the business shall notify the department, requesting that the department remove the business from the telemedicine business registry. If a business gives notification under this subsection, the business must submit a new application under (a) of this section before resuming the provision of telemedicine services to a recipient located in this state.

SOURCE: AK Admin Code. Sec. 600 & AK Dept. of Commerce, Community, and Economic Development, Occupational Licensing Centralized Regulations, Article 5. June 2021 & Division of Corporations, Business and Professional Licensing – Telemedicine Business Registry (Accessed Aug. 2022).

The following fees are established for registration under AS 44.33.381 (telemedicine business registry) for businesses performing telemedicine services in this state;

  • initial registration fee, $50;
  • fee to report changes in the information on the initial registration, $50.

SOURCE: AK Admin Code 12-02.106 (Accessed Aug. 2022).

A person who is licensed or registered under AS 08.11 may provide telemedicine services to a client in the state if:

  • The telemedicine services are of the same scope, nature, and quality as those services provided in person;
  • The quality of electronic transmissions used to provide telemedicine services allow the licensee or registrant to provide services equivalent to those provided in person;
  • The licensee or registrant has the skill and ability to operate the equipment used to provide telemedicine services;
  • The licensee or registrant assesses the client’s level of comfort in receiving telemedicine services and makes appropriate adjustments to the treatment plan based on that assessment;
  • The licensee or registrant ensures the presence of a telemedicine facilitator who is physically present with the client when appropriate;
  • The licensee or registrant ensures that the client can contact a licensed health care provider in person as part of the client’s treatment plan;
  • The licensee or registrant ensures that the electronic transmissions used to provide telemedicine services have sufficient security to ensure the protection of the client’s medical records as if the client were receiving in-person treatment; and
  • The licensee or registrant does not provide telemedicine services solely through written correspondence; however, written correspondence may be used to supplement telemedicine services.
Nothing in this section prevents the use of asynchronous telemedicine.
See telerehabilitation regulations for supervision requirements.

SOURCE: AK Admin Code Title 12, Sec. 54. 510-530. (Accessed Aug. 2022).

Last updated 08/15/2022

Online Prescribing

A health care provider licensed in this state may provide health care services within the health care provider’s authorized scope of practice to a patient in this state through telehealth without first conducting an in9 person visit.

A physician licensed in another state may provide health care services through telehealth to a patient located in the state as provided in this subsection, subject to the investigative and enforcement powers of the department under AS 08.01.087, and subject to disciplinary action by the State Medical Board under AS 08.64.333. The privilege to practice under this subsection extends only to (1) ongoing treatment or follow-up care related to health care services previously provided by the physician to the patient and applies only if

  • the physician and the patient have an established physician4 patient relationship; and
  • the physician has previously conducted an in-person visit with the patient; or
  • a visit regarding a suspected or diagnosed life-threatening condition for which the patient has been referred to the physician licensed in another state by a physician licensed in this state and that referral has been documented by the referring physician; and
  • the visit involves communication with the patient regarding diagnostic or treatment plan options or analysis of test results for the life threatening condition.

A physician, podiatrist, osteopath, or physician assistant licensed under AS 08.64 may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 – 11.71.190 if the physician, podiatrist, osteopath, or physician assistant complies with state and federal law governing the prescription, dispensing, or administering of a controlled substance.

An advanced practice registered nurse licensed under AS 08.68 may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 – 11.71.190 if the advanced practice registered nurse complies with state and federal law governing the prescription, dispensing, or administering of a controlled substance.

Except as authorized under (e) and (f) of this section, a health care provider licensed under this title may not prescribe, dispense, or administer through telehealth under this section a controlled substance listed in AS 11.71.140 – 11.71.190.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 08.01.085, (Accessed Aug. 2022).

The nursing board is required to establishing guidelines for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug to a person without conducting a physical examination under AS 08.68.710; the guidelines must include a nationally recognized model policy for standards of care of a patient who is at a different location than the advanced practice registered nurse.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 08.68.100, (Accessed Aug. 2022).

Nursing

The board may not impose disciplinary sanctions on an advanced practice registered nurse for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug that is not a controlled substance to a person without conducting a physical examination if

  • the advanced practice registered nurse or another licensed health care provider in the medical practice is available to provide follow-up care; and
  • the advanced practice registered nurse requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider if the prescribing advanced practice registered nurse is not the person’s primary care provider and, if the person consents, the advanced practice registered nurse sends the records to the person’s primary care provider

The board may not impose disciplinary sanctions on an advanced practice registered nurse for prescribing, dispensing, or administering a prescription drug that is a controlled substance if the requirements under (a) of this section and
15 AS 08.68.705 are met and the advanced practice registered nurse prescribes, dispenses, or administers the controlled substance.

Notwithstanding (a) and (b) of this section, an advanced practice registered nurse may not prescribe, dispense, or administer a prescription drug in response to an Internet questionnaire or electronic mail message to a person with whom the advanced
practice registered nurse does not have a prior provider-patient relationship.

SOURCE: AK House Bill 265 (2022 Session) and Sec. 08.68.710, (Accessed Aug. 2022).

The guiding principles for telemedicine practice in the American Medical Association (AMA), Report 7 of the Council on Medical Service (A-14), Coverage of and Payment for Telemedicine, dated 2014, and the Federation of State Medical Boards (FSMB), Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine, dated April 2014, are adopted by reference as the standards of practice when providing treatment, rendering a diagnosis, prescribing, dispensing, or administering a prescription or controlled substance without first conducting an in-person physical examination under AS 08.64.364.

During a public health emergency declared by the governor or commissioner of health and social services, an appropriate licensed health care provider need not be present with the patient to assist a physician or physician assistant with examination, diagnosis, and treatment if the physician or physician-assistant is prescribing, dispensing, or administering buprenorphine to initiate or continue treatment for opioid use disorder and the physician or physician assistant

  •  is a waived practitioner under 21 U.S.C 823(g)(2) (Drug Addiction Treatment Act (DATA));
  • documents all attempts to conduct a physical examination under AS 08.64.364(b), the reason why the examination cannot be performed, and the reason why another health care provider cannot be present with the patient; and
  • requires urine or oral toxicology screening as part of the patient’s medication adherence plan.

SOURCE: AK Admin. Code, Title 12, Sec. 40.943 (Accessed Aug. 2022).

The board may not impose disciplinary sanctions on a physician or physician assistant for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug that is not a controlled substance to a person without conducting a physical examination if:

  • the physician, physician assistant, or another licensed health care provider in the medical practice is available to provide follow-up care; and
  • the physician or physician assistant requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider if the prescribing physician or physician assistant is not the person’s primary care provider and, if the person consents, the physician or physician assistant sends the records to the person’s primary care provider.

The board may not impose disciplinary sanctions on a physician or physician assistant for prescribing, dispensing, or administering a prescription drug that is a controlled substance if certain requirements are met.

A physician or physician assistant may not prescribe, dispense, or administer an abortion-inducing drug under (a) of this section unless the physician complies with AS 18.16.010; and a physician or physician assistant may not prescribe, dispense, or administer a prescription drug in response to an Internet questionnaire or electronic mail message to a person with whom the physician or physician assistant does not have a prior physician-patient relationship.

SOURCE: Alaska Statute Sec. 08.64.364 as amended by AK House Bill 265 (2022 Session) (Accessed Aug. 2022).

Physicians are prohibited from prescribing medications based solely on a patient-supplied history received by telephone, FAX, or electronic format.

Unprofessional conduct includes the following:

  • For a physician or physician assistant, prescribing, dispensing, or furnishing a prescription medication without first conducting a physical examination of the person, unless the licensee has a patient-physician or patient-physician assistant relationship with the person; this paragraph does not apply to prescriptions written or medications issued
    • For use in emergency treatment;
    • For expedited partner therapy for sexually transmitted diseases;
    • In response to an infectious disease investigation, public health emergency, infectious disease outbreak, or act of bioterrorism; or
    • By a physician or physician assistant practicing telemedicine under AS 08.64.364;

SOURCE: AK Admin. Code, Title 12, Sec. 40.967. (Accessed Aug. 2022).

Nursing

An advanced practice registered nurse (APRN) may practice telehealth, including prescribing, dispensing, or administering a prescription drug that is not a controlled substance if:

  • the APRN is licensed by the board;
  • the APRN, or another licensed health care provider in a group practice, is available to provide follow-up care; and
  • the APRN requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider if the prescribing APRN is not the person’s primary care provider and, if the person consents, the APRN sends the records to the person’s primary care provider.

An APRN may prescribe, dispense, or administer a prescription drug that is a controlled substance if certain requirements are met and the APRN prescribes, dispenses, or administers the controlled substance when an appropriate health care provider is present with the patient to assist the APRN with examination, diagnosis, and treatment.

During a disaster emergency declared by the governor, an appropriate health care provider need not be present with the patient to assist an APRN with examination, diagnosis, and treatment if the APRN is prescribing, dispensing, or administering buprenorphine to initiate treatment for opioid use disorder and the APRN

  • is a waived practitioner under 21 U.S.C. 823(g)(2) (Drug Addiction Treatment Act (DATA));
  • documents all attempts to conduct a physical examination under this section and the reason why the examination cannot be performed; and
  • requires urine or oral toxicology screenings as part of the patient’s medication adherence plan.

An APRN may not prescribe, dispense, or administer a prescription drug in response to an Internet questionnaire or electronic mail message to a person with whom the APRN does not have a prior APRN-patient relationship.

An “APRN-patient relationship” is established when there is an in-person health examination or examination by telehealth technology of the patient by the APRN or another APRN, physician, or physician assistant in the same group practice and the patient record is available to the treating APRN.

SOURCE: AK Admin Code Title 12, 44.925 (Accessed Aug. 2022).

Last updated 08/15/2022

Professional Requirements

Medical Board

SOURCE: AK Admin. Code, Title 12, Sec. 40.943 (Accessed Aug. 2022).

Audiology & Speech-Language Pathology

SOURCE: AK Admin. Code, Title 12, Sec. 07.020. (Accessed Aug. 2022).

Physical therapists and occupational therapy

SOURCE: AK Admin Code Title 12, Sec. 54. 530 & 825 (Accessed Aug. 2022).

Board of Nursing

SOURCE: AK Admin Code Title 12, 44.925 (Accessed Aug. 2022).