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Alaska - Autism Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

In Alaska, Autism Services (Applied Behavior Analysis) are covered under the state's Medicaid program and regulated by the Department of Health (DOH), Division of Behavioral Health. Providers must be approved by the DOH and enrolled in Alaska Medicaid through the state's fiscal agent, Conduent (formerly HMS Gainwell), to bill for services.

The most critical structural requirement for providing these services in Alaska is that all autism providers billing Alaska Medicaid must have an active certification on file with Conduent, as mandated by 7 AAC 135.300. Individual rendering providers, such as licensed behavior analysts and autism behavior technicians, must enroll in Medicaid and affiliate with an approved provider group.

1. Service Definition and Scope

Alaska Medicaid covers Autism Services, which include behavior identification assessments, reassessments, and adaptive behavior treatment (Applied Behavior Analysis). These services are designed to treat individuals with autism spectrum disorder and are considered rehabilitative behavioral health services.

Services can be delivered in various settings, but they are generally not covered when a recipient is admitted to an acute care hospital, psychiatric hospital, or intermediate care facility, except for specific discharge planning authorized by the department.

2. Regulatory and Oversight Agencies

The Alaska Department of Health (DOH), Division of Behavioral Health (DBH) is the primary regulatory body overseeing behavioral health and autism services in the state. They establish provider qualifications and service standards.

Medicaid enrollment and claims processing are managed by the state's fiscal agent, Conduent (formerly HMS Gainwell), through the Alaska Medicaid Health Enterprise portal.

3. Gatekeeping Prerequisites: Who Can Even Apply

Before an individual provider can bill for autism services, they must be affiliated with an approved provider group that meets the standards under 7 AAC 105.200. Individual providers do not require a separate agency application but must enroll and affiliate.

Additionally, all autism providers must have an active certification on file with Conduent. Providers with expired certifications will be dis-enrolled from Alaska Medicaid.

4. Licensure and Certification Requirements

Providers of autism services in Alaska must hold the appropriate licensure or certification for their role. This includes Licensed Behavior Analysts (LBAs), Licensed Assistant Behavior Analysts (LABAs), and Autism Behavior Technicians.

Supervisors, such as LBAs and LABAs who supervise technicians, must complete supervisory training required by the Behavior Analyst Certification Board (BACB) or another approved certifying entity.

5. Medicaid Provider Enrollment

Providers must enroll in Alaska Medicaid through the Alaska Medicaid Health Enterprise portal. The enrollment process requires submitting a signed Provider Agreement and applicable application fees.

Once approved, the provider receives a Medicaid Provider Identification (ID) number. No services will be paid prior to the enrollment effective date.

6. Staffing, Training and Background Checks

All autism service providers, including LBAs, LABAs, and technicians, are subject to strict background check requirements under Alaska statutes. They must clear barrier crimes and criminal history checks.

Staff must operate within their scope of practice and maintain their specific certifications, such as BACB certification for technicians.

7. Documentation, Policies and Records

Providers must maintain detailed records of behavior identification assessments, reassessments, and treatment plans. Documentation must support the medical necessity of the services provided.

To avoid a break in treatment, providers must submit requests for additional authorized periods of autism services 14 days before the end of the previously authorized period, including a behavior identification reassessment.

8. Billing, Rates and Claims

Claims for autism services are processed by Conduent. Providers must bill using the appropriate CPT codes for ABA services as defined in the Behavioral Health Medicaid Provider Assistance fee schedules.

Medicaid will pay for authorized behavioral health clinic services or required medical services on the same day a recipient receives approved autism services.

9. Approval Sequence and Timeline

The approval process begins with obtaining the necessary individual licensure or certification (e.g., BACB certification, state license). Next, the provider must complete a background check.

Following background clearance, the provider applies for Medicaid enrollment via the Health Enterprise portal, affiliates with an approved group, and submits their active certification to Conduent.

10. Common Denials and Survey Findings

A frequent cause for dis-enrollment or denial of claims is the failure to maintain an active certification on file with Conduent. Providers with expired certifications are automatically dis-enrolled.

Additionally, failure to submit reauthorization requests 14 days prior to the expiration of the current treatment period can result in a break in treatment and denied claims for unauthorized services.

11. Key Contacts and Resources

Providers should utilize the Alaska Medicaid Health Enterprise portal for enrollment and the Division of Behavioral Health for policy guidance. Conduent handles direct enrollment inquiries.

For specific questions regarding autism provider certification, providers can contact the designated DBH staff member.

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