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CurrentAlaska MedicaidPolicy N/A

Podiatry Services Fee Schedule (SFY 2026)

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This document is the Alaska Medicaid podiatrist fee schedule for State Fiscal Year 2026 (7/1/2025–6/30/2026), listing CPT procedure codes, brief descriptions, and maximum allowable reimbursement amounts that apply to podiatry services billed to Alaska Medicaid.

Policy Summary

PayerAlaska Medicaid

PolicyPodiatry Services Fee Schedule (SFY 2026)

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJul 1, 2025

Next Review DateN/A

Key ActionReference the listed Maximum Allowable amounts when submitting podiatry claims and follow 'Refer to DME Fee Schedule' for DME/orthotic items.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

SFY 2026policy effective period

07/06/2025rate snapshot date

$2,297.96highest Maximum Allowable

$11.53–$56.06x‑ray range

~160+procedure lines shown (partial)

Coverage criteria and per-code billing stance

Authorization flags and maximum allowable per procedure

Line-item coverage stance and any indicated requirement flags

Line-item coverage stance: codes listed are covered with a 'Maximum Allowable' shown per procedure code.

Examples of explicit authorization flags on line items

Code 27700: Requires Medical Justification = X; Maximum Allowable = $1,206.41.
Code 27702: Requires Medical Justification = X; Maximum Allowable = $1,645.13.
Code 27703: Requires Comagine Authorization = X; Maximum Allowable = $1,905.50.

Policy Summary

PayerAlaska Medicaid

PolicyPodiatry Services Fee Schedule (SFY 2026)

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJul 1, 2025

Next Review DateN/A

Key ActionReference the listed Maximum Allowable amounts when submitting podiatry claims and follow 'Refer to DME Fee Schedule' for DME/orthotic items.

SourceLink

On This Page

Per-code billing entries (partial)

Per-code entries include description, authorization flags, NDC field, and maximum allowable.

Each listed CPT/HCPCS line includes: description, 'Requires Medical Justification', 'Requires Comagine Authorization', 'Requires Fiscal Agent Authorization', 'Requires NDC', and a 'Maximum Allowable' dollar amount (fields present but frequently blank in these excerpts).

Sample per-code billing entries (partial)

27860 — FIXATION OF ANKLE JOINT. Requires Medical Justification = . Requires Comagine Authorization = . Requires Fiscal Agent Authorization = . Requires NDC = . Maximum Allowable = $282.68.
27870 — FUSION OF ANKLE JOINT OPEN. Requires Medical Justification = . Requires Comagine Authorization = . Requires Fiscal Agent Authorization = . Requires NDC = . Maximum Allowable = $1,730.25.
27888 — AMPUTATION OF FOOT AT ANKLE. Requires Medical Justification = . Requires Comagine Authorization = . Requires Fiscal Agent Authorization = . Requires NDC = . Maximum Allowable = $980.21.
28001 — DRAINAGE OF BURSA OF FOOT. Requires Medical Justification = . Requires Comagine Authorization = . Requires Fiscal Agent Authorization = . Requires NDC = . Maximum Allowable = $283.18.
28002 — TREATMENT OF FOOT INFECTION. Requires Medical Justification = . Requires Comagine Authorization = . Requires Fiscal Agent Authorization = . Requires NDC = . Maximum Allowable = $403.93.

NDC and authorization flag fields are shown for each line; in this excerpt their values are generally blank (not required) unless an 'X' is indicated as above.

Billing limits and authorization placeholders

Billing stance and limits provided by code line items

Billing stance: procedure codes are listed as covered and include a 'Maximum Allowable' dollar amount for reimbursement.

Authorization placeholders: each CPT line includes fields for 'Requires Medical Justification', 'Requires Comagine Authorization', and 'Requires Fiscal Agent Authorization' which are present but not populated in many entries in this fragment.

Range and examples of Maximum Allowable values

28299 — Maximum Allowable = $1,625.22.
28300 — Maximum Allowable = $1,121.70.
28420 — Maximum Allowable = $2,180.07 (higher-allowable example).
X‑ray examples: 73630 — $37.91 / $52.64 (modifier-specific); 73660 — $11.53 / $33.02 / $44.55.
Office E/M examples: 99202 — $121.67; 99203 — $191.52.

Operational note: authorization fields act as placeholders for prior authorization or medical justification requirements; where an 'X' appears it indicates a requirement (see codes 27700–27703).

Per-code reimbursement entries

Per-code entries include description, authorization flags, and maximum allowable; where DME items appear, reimbursement is deferred to the DME fee schedule.

Per-code reimbursement: each CPT/HCPCS entry shows a 'Maximum Allowable' amount or a direction to another schedule; authorization flag fields are present for each entry.

Radiography and E/M examples

73630 — X‑RAY EXAM OF FOOT. Maximum Allowable = $37.91 and $52.64 (modifier-specific entries). Authorization fields present but blank.
73650 — X‑RAY EXAM OF HEEL. Maximum Allowable examples = $14.05, $30.09, $44.14 (modifier-specific). Authorization fields present but blank.
99202 — OFFICE O/P NEW SF 15 MIN. Maximum Allowable = $121.67. Authorization fields present but blank; 99204 shows fields similarly blank in excerpt.

DME / orthotics handling

A5512, A5513, L2106, L2108, L2112, L2114, L2116, L4360 — 'Requires' fields present but empty; Maximum Allowable = 'Refer to DME Fee Schedule' (reimbursement governed by separate DME fee schedule).

Operational note: when 'Refer to DME Fee Schedule' is shown, reimbursements for those HCPCS items follow the DME Fee Schedule rather than the podiatry fee lines in this document.

CPT/HCPCS codes and maximum allowable reimbursements

sample CPT codes and ratesCPTCovered

10060	I&D ABSCESS SIMPLE/SINGLE. Maximum Allowable = $207.96
10061	I&D ABSCESS COMP/MULTIPLE. Maximum Allowable = $354.61
11720	DEBRIDE NAIL 1-5. Maximum Allowable = $53.80
11730	Removal of nail plate. Maximum Allowable = $185.31
27610	Explore/treat ankle joint. Maximum Allowable = $1,101.72

sample sequential CPT/HCPCS procedure listings (partial)CPTCovered

27860	FIXATION OF ANKLE JOINT. Maximum Allowable = $282.68
27870	FUSION OF ANKLE JOINT OPEN. Maximum Allowable = $1,730.25
27888	AMPUTATION OF FOOT AT ANK. Maximum Allowable = $980.21

additional procedure entries (partial)CPTCovered

28001	DRAINAGE OF BURSA OF FOOT. Maximum Allowable = $283.18
28002	TREATMENT OF FOOT INFECTION. Maximum Allowable = $403.93
28003	TREATMENT OF FOOT INFECTI. Maximum Allowable = $636.10

higher-allowable procedures (partial)CPTCovered

28114	REMOVAL OF METATARSAL HE. Maximum Allowable = $1,765.43
28262	REVISION OF FOOT AND ANKLE. Maximum Allowable = $2,297.96
28261	REVISION OF FOOT TENDON. Maximum Allowable = $1,799.80

sample CPT entries and maximum allowable amounts from tableCPTCovered

28299	Procedural entry with Maximum Allowable = $1,625.22
28300	INCISION OF HEEL BONE — Maximum Allowable = $1,121.70
28420	TREAT/GRAFT HEEL FRACTUR — Maximum Allowable = $2,180.07
28705	ARTHRODESIS PANTALAR — Maximum Allowable = $2,125.44
28800	AMPUTATION OF MIDFOOT — Maximum Allowable = $926.55
73600	X-RAY EXAM OF ANKLE — Maximum Allowable amounts vary by modifier (examples shown in table)
73660	X-RAY EXAM OF TOE(S) — Maximum Allowable = $11.53, $33.02, $44.55
99202	OFFICE O/P NEW SF 15 MIN — Maximum Allowable = $121.67
99203	OFFICE O/P NEW LOW 30 MIN — Maximum Allowable = $191.52

Foot radiographyCPTCovered

73630	X-RAY EXAM OF FOOT. Maximum Allowable = $37.91 and $52.64 (examples by modifier)
73650	X-RAY EXAM OF HEEL. Maximum Allowable = $14.05, $30.09, $44.14 (examples by modifier)
73660	X-RAY EXAM OF TOE(S). Maximum Allowable = $11.53, $33.02, $44.55

Office/outpatient E/MCPTCovered

99202	OFFICE O/P NEW SF 15 MIN. Maximum Allowable = $121.67
99203	OFFICE O/P NEW LOW 30 MIN. Maximum Allowable = $191.52
99204	OFFICE O/P NEW MOD 45 MIN. Maximum Allowable = $290.83
99205	OFFICE O/P NEW HI 60 MIN. Maximum Allowable = $37.41
99211	OFF/OP EST MAY X REQ PHY/Q. Maximum Allowable = $37.41
99212	OFFICE O/P EST SF 10 MIN. Maximum Allowable = $95.26
99213	OFFICE O/P EST LOW 20 MIN. Maximum Allowable = $156.85
99214	OFFICE O/P EST MOD 30 MIN. Maximum Allowable = $222.25
99215	OFFICE O/P EST HI 40 MIN. Maximum Allowable = $313.86

DME/orthotics (redirected to DME fee schedule)HCPCSCovered

A5512	MULTI DEN INSERT DIRECT FO. Maximum Allowable = Refer to DME Fee Schedule
A5513	MULTI DEN INSERT CUSTOM M. Maximum Allowable = Refer to DME Fee Schedule
L2106	AFO TIB FX CAST PLASTER MO. Maximum Allowable = Refer to DME Fee Schedule
L2108	AFO TIB FX CAST MOLDED TO. Maximum Allowable = Refer to DME Fee Schedule
L2112	AFO TIBIAL FRACTURE SOFT. Maximum Allowable = Refer to DME Fee Schedule
L2114	AFO TIB FX SEMI-RIGID. Maximum Allowable = Refer to DME Fee Schedule
L2116	AFO TIBIAL FRACTURE RIGID. Maximum Allowable = Refer to DME Fee Schedule
L4360	PNEUMATI WALKING BOOT PR. Maximum Allowable = Refer to DME Fee Schedule

Rounding rule — RBRVS-based rates

Rounding ruleRBRVS-based rates are rounded to the nearest cent following adjustments for multiple units and cutbacks.

Rounding contextReimbursement may vary slightly from published rates as a result of rounding.

Effective period noteApplies to SFY 2026 fee schedule effective 7/1/2025–6/30/2026.

Highest shown maximum allowable — highlighted example

Highest shown Maximum Allowable$2,297.96

Associated code (example)CPT 28262 — Revision of foot and ankle — Maximum Allowable = $2,297.96

Rate snapshotAs of 07/06/2025

Maximum Allowable per code

Definition'Maximum Allowable' is the dollar amount listed on each CPT line that indicates the reimbursement for that procedure code.

Per-line presenceEach CPT code line in the table includes a 'Maximum Allowable' dollar amount (examples shown throughout the schedule).

Authorization fieldsAuthorization indicator fields may appear alongside the Maximum Allowable but are often blank in these excerpts.

Maximum allowable examples

X‑ray examples73630 Maximum Allowable = $37.91 and $52.64 (different modifiers); 73660 Maximum Allowable = $11.53, $33.02, $44.55.

E/M examples99204 Maximum Allowable = $290.83; 99202 = $121.67; 99203 = $191.52.

Surgical examples28299 Maximum Allowable = $1,625.22; 28300 = $1,121.70; 28420 = $2,180.07 (see table).

Authorization, justification, and provider billing requirements

Prior Authorization

Authorization and justification flags present

Many line items in the fee schedule include explicit authorization and justification flags on each line. Providers must check these per-code fields when submitting claims and prior authorization requests; absence of a flag in an excerpt does not remove the requirement if defined elsewhere in policy or system rules.

Per-code flags seen in the source: Requires Medical Justification, Requires Comagine Authorization, Requires Fiscal Agent Authorization, and Requires NDC.
Examples (non-exhaustive): CPT codes 10060, 11055, 27860, 28002, 28300, 73630, 99202–99205, and many others list these authorization/justification fields.

Documentation Required

Authorization indicators present but unspecified

Multiple entries list the authorization flags but the flag values are empty in the excerpt. Providers should not assume authorization is not required; verify in the payer portal, prior authorization tool, or the complete policy text to determine if prior authorization or documentation is required before performing the service.

Numerous CPT/HCPCS lines show the fields (e.g., Requires Medical Justification = .) with no value populated in this excerpt.
Operational action: Confirm authorization requirements in the Alaska Medicaid provider portal or contact Comagine (utilization management) and the fiscal agent when unsure.

Prior Authorization

Imaging authorization flags

Imaging/X‑ray codes explicitly include authorization fields. Prior authorization or documented medical justification may be required for radiographic exams depending on the clinical indication and payer rules.

X‑ray exam examples with flags: 73630 (X‑ray of foot), 73650 (X‑ray of heel), 73660 (X‑ray of toes) — each lists Requires Medical Justification, Requires Comagine Authorization, and Requires Fiscal Agent Authorization.
Check modifier and technical/component billing (TC, 26) and follow imaging-specific prior authorization pathways if flags are set.

Billing Rule

DME authorization and fee direction

Durable medical equipment (DME) and orthotic HCPCS lines show authorization flags and instruct providers to reference the separate DME fee schedule for pricing. DME often requires supporting documentation and prior authorization through DME workflows.

DME examples: A5512, A5513 (dental inserts), L2106/L2108/L2112/L2114/L2116 (AFO orthoses), L4360 (pneumatic walking boot) — all show the authorization fields and state "Refer to DME Fee Schedule" for maximum allowable amounts.
Operational action: For DME requests submit clinical justification, appropriate KX or modifier when applicable, and follow DME-specific prior authorization procedures; price claims per the Alaska Medicaid DME fee schedule.

Documentation Required

E/M service authorization flags

Office/outpatient evaluation and management (E/M) services in the schedule include authorization and justification fields. Even when fields are blank in an excerpt, providers must verify whether prior authorization or medical necessity documentation is required for specific services or levels of care.

E/M examples: 99202–99205 (new patient office), 99211–99215 (established patient office), 99221–99222 (initial hospital care) — each lists Requires Medical Justification, Requires Comagine Authorization, and Requires Fiscal Agent Authorization alongside Maximum Allowable amounts.
Action: Document the medical necessity in the chart and, where required, obtain prior authorization from Comagine or the fiscal agent before delivering higher-level E/M services.

Definitions and fee schedule scope notes

RBRVS-based rates — definition note

DefinitionRBRVS-based rates — fee schedule rates derived from the Resource-Based Relative Value Scale (RBRVS).

Rounding applicationRates are rounded to the nearest cent after adjustments for multiple units and cutbacks as noted in the schedule.

Policy scopeApplies to Alaska Medicaid podiatry fee schedule for SFY 2026 (effective 7/1/2025).

Laboratory services reimbursement

GovernanceLaboratory services (CPT range 80047–89398) are reimbursed under the Independent Laboratory Fee Schedule, not this podiatry schedule.

ReferenceSee Independent Laboratory Fee Schedule for lab codes and rates referenced in this document.

ApplicabilityThis podiatry fee schedule excludes lab reimbursement details; lab codes redirect to the lab schedule.

Telehealth services reimbursement

GovernanceReimbursement for services provided via telehealth is governed by the Telehealth Fee Schedule, not this podiatry fee schedule.

ReferenceSee Telehealth Fee Schedule for telehealth-specific reimbursement rules and rates.

ScopeThis document references telehealth reimbursement direction but does not list telehealth rates here.

Maximum Allowable — definition indicating the listed reimbursement amount per procedure

Definition'Maximum Allowable' indicates the listed reimbursement amount for the procedure code in the Alaska Medicaid fee schedule.

Displayed per codeEach CPT/HCPCS line shows a Maximum Allowable amount (single value or multiple values by modifier).

Use in claimsProviders should expect payment for the listed code to be subject to this Maximum Allowable unless other adjustments or prior authorizations apply.

Authorization flags

Medical Justification flag'Requires Medical Justification' indicates whether clinical justification is required for the listed code (field present on line items).

Comagine Authorization flag'Requires Comagine Authorization' indicates whether authorization from Comagine is required for the code.

Fiscal Agent Authorization flag'Requires Fiscal Agent Authorization' indicates whether the fiscal agent must authorize the procedure.

Maximum Allowable — restated definition for clarity

Core definition'Maximum Allowable' — the dollar amount listed on each procedure line representing the fee schedule reimbursement for that code.

Multiple valuesSome entries show multiple Maximum Allowable values by modifier (e.g., TC, 26, etc.).

DocumentationThe Maximum Allowable is published alongside procedure descriptions and authorization indicators in the schedule table.

Authorization fields

Field purposeAuthorization indicator fields ('Requires Medical Justification', 'Requires Comagine Authorization', 'Requires Fiscal Agent Authorization') appear on each line to signal any required approvals.

Field valuesIn the provided excerpts these authorization fields are typically blank; some codes show an 'X' when required (examples in the schedule).

Provider actionIf an authorization flag is present and marked, providers must obtain the indicated authorization before billing.

Maximum Allowable — alternate chunk references for definition

Alternate wording'Maximum Allowable' = the dollar amount listed per CPT/HCPCS code that represents the scheduled reimbursement.

PlacementShown on each code line in the fee schedule table next to the procedure description.

ExampleSee CPT 28299 Maximum Allowable = $1,625.22 as an illustration of a per-code Maximum Allowable entry.

DME redirection — 'Refer to DME Fee Schedule' meaning

DME redirectionEntries with 'Maximum Allowable = Refer to DME Fee Schedule' indicate reimbursement for these HCPCS/DME items is governed by the separate DME Fee Schedule.

ExamplesCodes A5512, A5513, L2106, L2108, L2112, L2114, L2116, L4360 are listed with 'Refer to DME Fee Schedule'.

Provider instructionProviders must consult the DME Fee Schedule for pricing and billing guidance for these items.