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the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900:

(1) garments;

(2) liners;

(3) underpads;

(4) nonsterile gloves;

(5) diaper wipes;

(6) disposable washcloths. (h) For a rental period that is 30 days or more, the department will pay for rented durable medical equipment at the lesser of a monthly rental rate of 10 percent of the allowed purchase rate under this section or the billed rental charge, except

(1) codes that are from the Healthcare Common Procedure Coding System (HCPCS), adopted by reference in 7 AAC 160.900, that are defined as rental codes or with a specific rental rate listed on the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, may pay at the rental price listed on the Alaska Medicaid DMEPOS Fee Schedule or Alaska Medicaid DMEPOS Interim Fee Schedule:

(2) capped rental items or services may be paid at the rental rate listed on the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, or on the Alaska Medicaid DMEPOS Interim Fee Schedule up to the lesser of the purchase price of the item or 13 months’ worth of continuous rental. (i) For a rental period that is less than 30 days, the department will pay for rented durable medical equipment, medical supplies, prefabricated off-the-shelf orthotics, or related items and services under 7 AAC 120.200(a)(2) at a monthly rental rate of 150 percent of the monthly fee in (h) of this section, divided by the number of days in the month, times the number of days in the rental period. Payment may not exceed the monthly rate. Codes that are from the Healthcare Common Procedure Coding System (HCPCS), adopted by reference in 7 AAC 160.900, that are defined as daily rental codes or with a specific daily rate identified on the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, will pay at the lesser of the rental price listed on the Alaska Medicaid DMEPOS Fee Schedule, the Alaska Medicaid DMEPOS Interim Fee Schedule, or the billed rental rate. (j) A provider enrolled under 7 AAC 105.210 as a durable medical equipment provider may submit claims and payment may be authorized at a rate higher than the state-based rate published on the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, for a more costly, medically necessary item of durable medical equipment, medical supply, prefabricated off-the-shelf orthotic, or related item or service under 7 AAC 120.200(a)(2) if the recipient’s medical condition substantiates the need, and documentation is submitted with the claim that demonstrates, as follows, that a less expensive product is not