Billing Manuals

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Claim Form Instructions

Billing Manuals

The billing manuals for the Alaska Medical Assistance Program contain documentation pertinent to participation in the program and to use in the preparation of claim forms. Before submitting any type of claim, a provider must be enrolled as an Alaska Medical Assistance Provider. Provider Enrollment Applications can be downloaded from this web site or by calling Provider Services at (907) 644-6800 in Anchorage or outside the state of Alaska and at (800) 770-5650 from other locations in Alaska.

The following Provider Billing Manuals are available online:

Title	Size	Last Modified
Title	Size	Last Modified
Ambulatory Surgical Care Facilities	6,231 KB	04/23/2003
Chiropractic Services	6,837 KB	08/29/2006
Community Behavioral Health Clinic Services, Policies and Procedures Professional Claims Management General Program Information	1,805 KB 331 KB 623 KB	06/29/2012 05/09/2013 03/15/2013
Consumer Directed Personal Care Agency Revisions have been made to Table I-2 on pg. I-10 and Table I-3 on pg. I-19. Eligibility Codes Update to Table I-2 on pg. I-10 Procedure Code (Fee Schedule) Update to Table I-3 on pg. I-19	4,667 KB 10 KB 10 KB	04/23/2003 05/25/2010 05/25/2010
Dental Services	8,224 KB	09/30/2004
Direct-Entry Midwives Services, Policies and Procedures Professional Claims Management General Program Information	148 KB 331 KB 623 KB	05/02/2013 05/09/2013 03/15/2013
Durable Medical Equipment, Medical Supplies, Respiratory Therapy Assessment Visits, Prosthetics, Orthotics, and Home Infusion Therapy	5,235 KB	06/12/2007
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services	7,688 KB	08/11/2003
End Stage Renal Disease (ESRD) Dialysis Facility Services
Family Planning Clinic Services	8,278 KB	04/25/2008
Federally Qualified Health Center/Rural Health Clinic Services	5,788 KB	03/19/2003
Hearing Services	3,965 KB	09/08/2006
Home & Community Based Waiver Services – Care Coordination
Home & Community Based Waiver Services – Environmental Modifications
Home & Community Based Waiver Services – Home and Community-Based Agency
Home & Community Based Waiver Services – Residential Supported Living/ Assisted Living Homes
Home Health Services	7,342 KB	04/25/2008
Hospice Care Services	5,347 KB	12/13/2006
Independent Laboratory Services	7,365 KB	02/17/2005
Inpatient/Outpatient Hospital Services, Policies and Procedures Institutional Claims Management General Program Information	227 KB 325 KB 623 KB	04/17/2013 04/17/2013 03/15/2013
Inpatient Psychiatric Services	6,677 KB	04/25/2008
Long-Term Care Facility Services	7,653 KB	01/17/2007
Mental Health Physician Clinic Services, Policies and Procedures Professional Claims Management General Program Information	1,350 KB 331 KB 623 KB	06/29/2012 05/09/2013 03/15/2013
Nutrition Services	8,428 KB	08/18/2004
Personal Care Agency Services Revisions have been made to Table I-3 on pg. I-11 and Table I-4 on pg. I-19. Eligibility Codes Update to Table I-3 on pg. I-11 Procedure Code (Fee Schedule) Update to Table I-4 on pg. I-19
Pharmacy Services, Policies and Procedures Pharmacy Claims Management General Program Information	227 KB 546 KB 623 KB	03/20/2012 09/28/2012 03/15/2013
Physician, Advanced Nurse Practitioner, and Physician Assistant Services, Policies and Procedures Professional Claims Management General Program Information	248 KB 331 KB 623 KB	05/10/2013 05/09/2013 03/15/2013
Podiatry Services	9,726 KB	08/13/2004
Private Duty Nursing Services	7,615 KB	04/25/2008
School-Based Services	3,516 KB	05/08/2006
Targeted Case Management Services for the Infant Learning Program	3,359 KB	12/13/2006
Therapy Services, Policies and Procedures Professional Claims Management General Program Information	176 KB 331 KB 623 KB	05/10/2013 05/09/2013 03/15/2013
Transportation/Accommodation Services
Tribal Facilities Tribal Facility Services Billing Manual Appendix G: Covered Codes for CHA/P Appendix I: Covered Dental Health Aide Codes	4,320 KB 88 KB 51 KB	07/31/2012 04/02/2013 04/02/2013
Vision Services	6,314 KB	10/14/2003
X-Ray Services	8,655 KB	08/26/2004

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