Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 110 - Medicaid Coverage; Professional Services
Article 9 - Nutrition Services
7 AAC 110.275 - Nutrition services for recipients under 21 years of age

Universal Citation: 7 AK Admin Code 110.275

Current through November 28, 2024

(a) The department will pay for outpatient nutrition services provided to a recipient under 21 years of age who, consistent with the criteria in (b) of this section, is determined to be at high risk nutritionally by a physician, an advanced practice registered nurse, or another licensed or certified health care practitioner who may order those services within the scope of the practitioner's license or certification.

(b) A recipient under 21 years of age is at high risk nutritionally if the recipient

(1) has a flat growth curve or failure to thrive;

(2) has an atypical height-to-weight ratio, head circumference, or sudden weight change;

(3) has a hemoglobin count of less than 10 grams or a hemostat of less than 30 percent;

(4) has a weight of 2,500 grams or less, or a gestation of 36 weeks or less at birth;

(5) has a chronic disease or condition, including diabetes, cystic fibrosis, kidney disease, cancer, colitis, hypertension, diarrhea, constipation, anemia, and infection;

(6) has a congenital anomaly or genetic disorder, including cleft lip or palate, Down syndrome, spina bifida, heart disease, and phenylketonuria;

(7) is pregnant or breast-feeding; or

(8) has a growth problem with a nutritional condition that requires a special formula or diet.

(c) Except as provided in 7 AAC 110.200(3), the department will pay for the following nutrition services provided to a recipient who meets the requirements of (a) and (b) of this section:

(1) one initial assessment, not to exceed one hour, in a calendar year;

(2) up to 12 hours of services in a calendar year for counseling and follow-up care after the initial assessment for counseling and follow-up care;

(3) more than 12 hours of service in a calendar year if those hours are
(A) medically justified and prescribed by a physician, an advanced practice registered nurse, or a physician assistant, who may order those services within the scope of the practitioner's license; and

(B) given prior authorization by the department.

(d) The department will pay an independently practicing enrolled provider of nutrition services directly. If a provider of nutrition services provides services as a member of the staff of a hospital or other facility that is a Medicaid provider, the department will make payment to the facility. The department will not separately pay for inpatient nutrition services provided to a recipient in a hospital or nursing facility.

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040

Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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