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Editor’s note: Quarterly current and historical Centers for Medicare and Medicaid Services (CMS) Medicare DMEPOS Fee Schedules are available on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DME-POSFeeSched/DMEPOS-Fee-S chedule.html. The department’s Alaska Medicaid DMEPOS Interim Fee Schedule and Alaska Medicaid DMEPOS Price Research Form, referenced in 7 AAC 145.420, may be obtained from the Department of Health, Division of Health Care Services, 4501 Business Park Boulevard, Building L, Anchorage, Alaska 99503-7167, or at

http://www.medicaidalaska.com/providers/FeeSchedule.asp and www.medicaidalaska.com/providers/forms.html. 7 AAC 145.421. Prosthetics and orthotics payment rates. (a) Payment by the department to a provider that is enrolled under 7 AAC 120.300 as a prosthetics and orthotics provider will be made in accordance with 7 AAC 145.020. (b) A provider enrolled under 7 AAC 120.300 as a prosthetics and orthotics provider providing prosthetics, orthotics, related medical equipment, items, and supplies to eligible recipients may submit claims covered by the Healthcare Common Procedure Coding System (HCPCS), adopted by reference in 7 AAC 160.900, for which a rate has been established by CMS or the department or for covered codes with rate-setting methodologies set out in (c) — (e) of this section, as follows:

(1) payment rates set by the department for items and services provided by providers enrolled under 7 AAC 120.300 to recipients physically located in this state will be based on 100 percent of the current quarter’s Medicare DMEPOS Fee Schedule established by CMS for these items and services in this state, except items and services billable only by providers enrolled under 7 AAC 120.300 will be based on 120 percent of the current quarter’s Medicare DMEPOS Fee Schedule established by CMS for these items and services in this state;

(2) payment rates set by the department for items and services provided by providers enrolled under 7 AAC 120.300 who provide services to recipients when the recipients are physically located outside of this state will be based on 100 percent of the current quarter’s Medicare DMEPOS Fee Schedule established by CMS for these items and services in the state where the item or service was provided; the department will base location on the provider’s Medicare accreditation location address;

(3) payment rates set by the department for items and services not established on the current quarter’s Medicare DMEPOS Fee Schedule established by CMS will be based on the rate-setting methodology set out in (c) — (f) of this section. (c) Payment rates for prosthetics, orthotics, or related items and services under 7 AAC 120.300(a)(2) for covered non-miscellaneous codes that are from the Healthcare Common Procedure Coding System (HCPCS), adopted by reference in 7 AAC 160.900, but for which