Adult Preventive Services Coverage
Customize your policy alerts
Sign up for all Alaska Medicaid policy alerts
Know when Alaska Medicaid releases new policies or updates existing guidance.
Monitor payer policy activity
Defines Alaska Medicaid coverage expansion to include a range of preventive services for members aged 21 and older beginning March 3, 2023, and outlines impacts for providers and members.
Alaska Medicaid will cover preventive services for members 21 years of age and older beginning March 3, 2023.
Services covered under the Adult Preventive Services Program will be excluded from member cost-sharing responsibilities (no copays).
Coverage criteria for adult preventive services
Source-aligned preventive service coverage
Covered when at least one of the following sources recommends the service for adults aged 21 and older:
Applies to preventive services recommended with an A or B grade by USPSTF
Includes HRSA women's preventive services recommendations
There is no change in immunization coverage; continue to follow the Immunization Services Billing Manual for specifics
There is no change in coverage for immunizations. Providers should continue to follow the Immunization Services Billing Manual for details on which immunizations are covered and the correct billing procedures.
Coding and billing
| No codes listed |
Provider responsibilities and billing impacts
Prior authorization — monitor guidance
No specific prior authorization requirements are stated in this announcement; providers should monitor the forthcoming billing manual and provider guidance for any prior authorization rules that may be published.
Step therapy — none specified
There are no step therapy requirements specified in this announcement for covered adult preventive services.
Follow updated billing manual and fee schedules
Follow the new adult preventive services billing manual and updated fee schedules when they are released to ensure correct billing, reimbursement, and application of copay exclusions.
- A new billing manual will describe services, coverage criteria, billing guidance, and how copay exclusions are applied to claims.
- Applicable provider fee schedules will be updated to include covered adult preventive services.
Copay collection risk — do not collect
Do not collect a member copay for services covered under the Adult Preventive Services Program; collecting a copay may trigger noncompliance or require claim adjustments.
- Services covered under the program are excluded from member cost‑sharing responsibilities.
- The billing manual will include guidance to ensure copay exclusions are applied to your claims.
Policy background and rationale
Alaska Medicaid expanded coverage effective March 3, 2023 to align adult preventive services with major federal guidance. Covered services for members aged 21 and older now include preventive care recommended by the USPSTF (A/B recommendations), services identified under HRSA women’s preventive services, and immunizations consistent with the CDC immunization schedules.
The expansion is intended to improve early detection and prevention of conditions such as cancers, diabetes, infectious diseases, and behavioral health concerns by including screenings, counseling, immunizations, contraception, and preventive medications when they are recommended by these authoritative sources.
Key definitions and referenced guidance
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.