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The department’s Alaska Medicaid DMEPOS Interim Fee Schedule and Alaska Medicaid DMEPOS Price Research Form, referenced in 7 AAC 145.421, 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 145.425. Home infusion therapy payment rates. (a) Except as otherwise provided in this section, when the only home infusion therapy service being provided is skilled nursing, the department will pay a provider of home infusion therapy services for skilled nursing services in accordance with 7 AAC 145.020, not to exceed 85 percent of the amount determined under 7 AAC 145.050 per visit. (b) The department will pay a provider on a per diem basis, for the duration of the therapy period, for home infusion therapy services and specialty drug administration when the home infusion therapy includes the concurrent delivery of home infusion administrative services, professional pharmacy services, care coordination, and necessary supplies and equipment; the per diem amount is determined as follows:

(1) the department will pay a percentage of the maximum allowed amount under (2) and (3) of this subsection that is

(A) 100 percent for the first administered therapy;

(B) 80 percent for the second concurrently administered therapy; and

(C) 75 percent for the third and each subsequent concurrently administered therapy;

(2) the maximum allowed amount in CPT Fee Schedule for Home Infusion Therapy Services table and HCPC Fee Schedule for Home Infusion Therapy Services table, adopted by reference in 7 AAC 160.900;

(3) for services not listed on the fee schedule adopted by reference in (2) of this subsection, a maximum allowed amount that the department will establish based on 80 percent of the billed charges from enrolled providers in this state for the first nine billings that reflect a charge for a home infusion therapy service not already on the schedule established under this subsection; thereafter, the payment rate will be established based on the 50th percentile of the first 10 billings; the department will add new payment rates under this subsection each time the department receives 10 billings for a home infusion therapy service not already on the schedule; to be paid under this paragraph, a billing must reflect a charge that complies with the applicable standards in 7 AAC 145.020. (c) For home infusion therapy services for which a payment rate has not been determined under (a) or (b) of this section, the department will pay a home infusion therapy provider at a reasonable per diem rate determined under (d) of this section for the duration of the therapy