Alaska's rule lists six paid autism services, from "initial behavior identification assessment" through "adaptive behavior treatment by protocol modification," and a recipient must be "under 21 years of age" with a qualifying diagnosis "as determined by either a mental health professional as defined in AS 47.30.915 or a health care professional who is qualified" to diagnose autism in children (7 AAC 135.350, akleg.gov print view). The print view carries no history note, but it shows a repeal dated July 1, 2025, so it reflects at least the amendments in force then. Every health.alaska.gov fee schedule request returned an HTTP 403, so no rate chart was read.
The text read shows a repeal of subsection (g) dated July 1, 2025. Search results referenced a 2025 proposal to remove prior-authorization requirements for autism services, and this guide confirmed only the text of 7 AAC 135.040(c)(19), which lists autism services among services a provider may deliver without prior authorization. Confirm the current rule and the rate chart with the department.
The reimbursement criteria at a glance
- Is ABA covered by Alaska Medicaid
- Who is eligible: age, diagnosis, and documentation
- Who may bill, and who may render
- Place of service
- Prior authorization and reauthorization
- The commercial mandate
- Practices with in-house diagnostics versus ABA-only practices
- How this connects to the rest of your compliance stack
- Getting set up to bill Alaska Medicaid: the sequence
- What this guide could not verify
- Alaska reimbursement variables at a glance
- Frequently asked questions
- Where professional advice is essential
Is ABA covered by Alaska Medicaid
Yes. Under 7 AAC 135.350, "the department will pay for the following rehabilitative autism services provided to a recipient listed in 7 AAC 135.020(e) or (f) if provided by a provider identified in 7 AAC 135.300": initial behavior identification assessment, behavior identification reassessment, adaptive behavior treatment by protocol, group adaptive behavior treatment by protocol, family adaptive behavior treatment guidance, and adaptive behavior treatment by protocol modification (7 AAC 135.350(a)). The rule also allows these services to be paid "during the same 15-minute time increment as a Medicaid covered service," specifically adaptive behavioral health treatment by protocol and by protocol modification (7 AAC 135.350(n)).
Who is eligible: age, diagnosis, and documentation
To be eligible, a recipient must "be under 21 years of age," have a qualifying diagnosis of autism spectrum disorder, and "provide documentation, completed by a licensed behavior analyst" that includes an assessment under the rule and "indicates that the requested autism services are expected to result in measurable improvement in either the recipient's behaviors, skills, or both." The initial assessment draws on "a referral from a mental health professional, as defined in AS 47.30.915, or a health care professional who is qualified" to assess and diagnose autism in children (7 AAC 135.350(e)).
Who may bill, and who may render
To qualify for payment, "a provider must be a community behavioral health services provider, a behavior analyst who meets the requirements in (c) of this section, or a behavior analyst group practice enrolled under 7 AAC 105.210." A behavior analyst must be enrolled as an independent provider and "currently certified by the Behavior Analyst Certification Board, Inc., or another certifying entity approved under AS 08.15.020(a)(4)." Technicians enroll separately: an autism behavior technician must be "enrolled as an autism behavior technician and a rendering provider" and be "currently registered by the Behavior Analyst Certification Board, Inc., currently certified by the Behavior Intervention Certification Council, or currently registered or certified by a similar organization approved by the department." Licensed behavior analysts, licensed assistant behavior analysts, and technicians are all subject to criminal history checks under AS 47.05.300 to 47.05.390 and 7 AAC 10.900 to 7 AAC 10.990 (7 AAC 135.300).
Place of service
Autism services may be provided in "the recipient's home, school, and community," in "a behavior analyst's office," in "an outpatient clinic," or in "another appropriate community setting." They are not paid when provided to a patient in an outpatient hospital, general acute care hospital, inpatient psychiatric hospital, residential psychiatric treatment center, intermediate care facility, skilled nursing facility, or intermediate care facility for individuals with an intellectual disability or related condition, "except for services for which the department gives prior authorization to specifically assist the recipient with discharge planning." The rule also excludes services provided by a recipient's immediate family member, foster parent, or legal guardian (unless a court has authorized the guardian), and assisting a recipient with school work "for the sole purpose of education" (7 AAC 135.350(j) and (k)). No ABA-specific telehealth rule was found in 7 AAC 135.350.
Prior authorization and reauthorization
Alaska's rule on services a community behavioral health provider may deliver without prior authorization lists "autism services provided in accordance with 7 AAC 135.350" (7 AAC 135.040(c)(19)). The autism rule has its own continuity requirement: "To avoid a break in treatment, a provider of autism services shall submit a request for additional authorized periods of autism services 14 days before the end of the previously authorized period of treatment," with a behavior identification reassessment and an updated treatment plan. The reassessment must include "an estimated timeline and number of treatment hours necessary to achieve each of the recipient's treatment goals" (7 AAC 135.350(m)). The two provisions read together are not fully consistent on their face, and this guide did not resolve how the department applies them. Whether any managed care organization or administrator runs the benefit was not verified.
The commercial mandate
AS 21.42.397, enacted by Session Laws of Alaska 2012, chapter 63, requires a health care insurer to "provide coverage for the costs of the diagnosis and treatment of autism spectrum disorders," including "applied behavior analysis or other structured behavioral therapies." Coverage is "required to be provided only to individuals under 21 years of age" and the insurer "may not limit the number of visits to an autism service provider for treatment." Small employers with 20 or fewer employees are exempt, and no dollar cap is stated. It applies to policies "offered, issued for delivery, delivered, or renewed on or after January 1, 2013" (SLA 2012, ch. 63). The codified statute as amended after 2012 was not read.
Practices with in-house diagnostics versus ABA-only practices
Alaska lets the diagnosis come from a mental health professional or a qualified health care professional, so a practice with a psychologist or physician on staff can keep the diagnostic step in-house, while an ABA-only practice depends on outside diagnosticians. Either way, a licensed behavior analyst must complete the documentation that supports the request.
How this connects to the rest of your compliance stack
The licensing credentials the rule relies on are on the Alaska Licensing page, and the entity analysis is on the Alaska entity page.
Getting set up to bill Alaska Medicaid: the sequence
- Choose the enrolled provider type. Community behavioral health services provider, behavior analyst, or behavior analyst group practice.
- Enroll behavior analysts and technicians separately. Each needs its own enrollment, current certification, and a criminal history check.
- Complete the licensed behavior analyst's documentation. It must include the assessment and the expected measurable improvement.
- Calendar the reauthorization. The request for additional authorized periods is due 14 days before the prior period ends.
What this guide could not verify
- Rates for 97151 to 97158. The department's fee schedule documents returned HTTP 403, and search-result figures are not quoted.
- Managed care status and any hour limits in a rate chart.
- Whether the 2025 proposed removal of autism prior authorization requirements was adopted in full, beyond the 7 AAC 135.040(c)(19) text.
- An ABA-specific telehealth rule. None was found in 7 AAC 135.350.
- The Medicaid state plan page for autism services, and the codified AS 21.42.397 as amended after 2012.
Alaska reimbursement variables at a glance
| Variable | Alaska value |
|---|---|
| ABA covered by Medicaid? | Yes, as autism services (7 AAC 135.350) |
| Age | Under 21 |
| Diagnosis | Mental health professional or qualified health care professional |
| Provider types | Community behavioral health services provider; behavior analyst; behavior analyst group practice; technicians enroll separately |
| Rates | Not verified |
| Settings | Home, school, community, behavior analyst's office, outpatient clinic, other community setting |
| Reauthorization | Request 14 days before the prior period ends |
| Commercial mandate | AS 21.42.397: under 21, no visit limit, no dollar cap stated, small employers of 20 or fewer exempt |
Frequently asked questions
Does Alaska Medicaid cover ABA?
Can technicians bill?
Where can services be delivered?
Does the commercial mandate cap ABA?
Where professional advice is essential, not optional
Alaska's rule is detailed on who qualifies and where services can be delivered, and this guide could not read the rates. Bring in a billing specialist to work from the department's current fee schedule and to confirm how prior authorization applies to autism services.
The governing authorities to know are 7 AAC 135.300 and 135.350 and AS 21.42.397.
This page describes rules read from the Alaska Legislature's administrative code print view and the 2012 session law. The department's fee schedules could not be read. The Department of Health, the state insurance regulator, and each payor provide current requirements. Do not rely on this page or any secondary source in place of direct verification.