Behavioral health Medicaid rates in Alaska sit near the top of the country almost everywhere they can be compared. Alaska Medicaid pays $31.51 per 15 minutes for code H2019 therapeutic behavioral services, which is $126.04 an hour, ranks 6th of 28 states and runs 43.5% above the $87.82 national median. The same pattern shows up in assessments, psychotherapy and residential care, and it is paired with clinician wages that are also well above the national level.
Every rate below is compiled from official state Medicaid publications, and each one on the state pages links to its source document. For the national picture across all service lines, see the behavioral health Medicaid rates by state hub.
H2019 is the one Alaska behavioral health service with a direct national rank, and it tells a clear story. At $126.04 an hour, Alaska trails only a short list of states: Maine at $449.72, Wyoming at $149.80, Washington at $145.40, Idaho at $142.44 and Ohio at $128.96. At the other end, Wisconsin pays $21.44, Arizona $19.52 and Alabama $16.80 an hour.
For a community agency, the H2019 rate is the clearest benchmark for paraprofessional, hourly community work. The current Alaska figure has been effective since July 1, 2025. Therapeutic behavioral services are typically delivered one to one in homes, schools and community settings, so a rate in the upper tier is what lets an agency send staff to where clients are, which in Alaska often means long distances.
Alaska wages run high, which matters when reading a high rate. Federal occupational wage data for May 2025 puts the Alaska median for a psychiatric technician at $24.83 an hour, against $21.70 nationally. Against the H2019 hourly rate, that wage is 28.0% of the rate, leaving a margin of $90.75 an hour after a loaded wage. That is one of the widest cushions a behavioral health service line can show, and it is what makes community-based therapeutic work viable in a high-cost state.
| Role | Alaska median wage | US median wage |
|---|---|---|
| Mental health counselor | $38.83 | $28.53 |
| Mental health social worker | $27.26 | $28.98 |
| Clinical psychologist | $59.75 | $48.36 |
| Psychiatrist | $164.51 | $135.51 |
| Nurse practitioner | $74.60 | $63.61 |
Two details stand out. Counselors earn far more in Alaska than nationally, while mental health social workers earn slightly less than the US median. A clinic that staffs therapy with social workers rather than counselors carries a lower wage base against the same fee schedule. Psychiatry is expensive everywhere, and at $164.51 an hour the Alaska psychiatrist median is above most per-session outpatient rates, so psychiatric time is usually reserved for evaluation and medication management.
Where the margin goes
A margin after a loaded wage is not profit. In Alaska it has to cover travel, often by air to rural communities, plus supervision, documentation, scheduling and the hours lost to weather and cancellations. A rate that looks generous on paper is what makes those costs absorbable.
Alaska's outpatient rates are not ranked nationally, but the published figures can be read against the medians.
- Psychotherapy. Alaska pays $120.45 for code 90834, a 38-52 minute session, effective July 1, 2026. The national median for outpatient psychotherapy and diagnostic evaluation is $83.33; the top-paying states in that group are California ($302.03), New Mexico ($144.88) and North Dakota ($118.28).
- Assessment. Alaska pays $537.79 per assessment on code H0031. The national median for a non-physician mental health assessment is $125.00. Alaska's figure falls between California's $668.95 and Pennsylvania's $400.00, with Missouri's $687.46 at the very top.
- Service planning. Alaska publishes $198.70 per assessment for code T1007 with modifier V1. The national median for service plan development is $30.34, but that median mostly reflects per-unit H0032 rates, so the two measure different things.
The assessment figure is the one to watch. A per-assessment payment of that size reflects a bundled service, not a short time increment, so it should be compared with other bundled rates rather than with 15-minute units.
Alaska's behavioral health schedule mixes three pricing units, and reading them correctly is the first step in any budget.
Per 15 minutes
H2019 and similar community services are priced per 15-minute unit. Revenue scales directly with time delivered, so documentation of start and stop times drives payment.
Per session
Psychotherapy codes such as 90834 are priced per session within a time band. A session that runs to the top of the band earns the same as one at the bottom, so scheduling to the band, rather than to the clock, protects clinician capacity.
Per assessment
H0031 and T1007 are priced per completed assessment or plan. Their value depends on how long a full assessment takes in practice; an efficient intake process turns a bundled rate into a strong hourly return.
Alaska's psychiatric residential treatment rate is $882.25 a day, effective July 1, 2026. The national median is $525.10. Minnesota ($1,244.07), Ohio ($1,092.60), Oregon ($1,003.95) and New York ($995.49) pay more, and Nevada pays $800.00. The lowest states are Louisiana ($448.73), Wyoming ($443.78) and Nebraska ($283.19).
The Alaska rate comes from the chart of psychiatric residential treatment facility rates for in-state Level V and VI providers. For a facility, a daily rate is the whole revenue for a bed day: staffing around the clock, clinical services, food and the building all come out of it. A rate well above the median reflects both the intensity of the care and Alaska's cost of operating a facility.
Alaska updated its behavioral health schedules on July 1, 2026, and two more notices are open.
- 1115 waiver services. The chart of behavioral health reform 1115 waiver services rates effective July 1, 2026 shows a 21.17% change, the largest movement in Alaska's behavioral health schedules this year.
- Community behavioral health and physician clinics. The chart of community behavioral health and mental health physician clinic services rates moved 3.2% on the same date.
- Residential and psychologists. The psychiatric residential treatment facility chart and the independent psychologist fee schedule each moved 3.2%.
- Proposed changes. A notice published September 3, 2026 (OPN 225041) proposes changes to 1115 waiver rates for subacute stabilization and residential services. The 2026 annual rate update state plan amendment notice (OPN 224328) was published June 30, 2026.
Providers billing under the Alaska 1115 Behavioral Health waiver services program saw the biggest step up this year, and the open notice means residential and stabilization rates may move again. The 3.2% figure matches the increase applied across several other Alaska schedules for SFY 2027, so it reads as an annual adjustment rather than a targeted change.
Alaska Medicaid covers all enrollees through fee-for-service, alongside Denali KidCare for children. Behavioral health is billed under the Alaska Medicaid behavioral health services program of the Division of Behavioral Health and under the 1115 waiver, so the published rate is the rate a provider is paid. Our data counts 3 plans and arrangements in the state; see the Alaska managed care page for how they relate to the fee schedule.
On coverage, none of the eight core psychotherapy codes in Alaska (90785, 90791, 90792, 90832, 90833, 90834, 90836 and 90837) carries a prior-authorization rule or a published unit limit. Family and group codes such as 90846, 90847 and 90853 are also free of authorization rules. That keeps outpatient therapy simple to bill compared with states that cap annual sessions.
Because Alaska runs behavioral health through both the State Plan program and the 1115 waiver, the same type of service can sit on different rate charts depending on the program. The two moved by very different amounts in July 2026, so the program assignment now has a larger effect on revenue than it did a year earlier. Providers should confirm, for each service line, which chart applies and keep billing systems aligned with the current SFY 2027 schedules.
Alaska pays well above the median on every behavioral health service it publishes, from H2019 to residential care. It does not lead the country on any single service, but it is consistently in the upper tier, which matches its higher wage costs. Compare with Maine, the top H2019 payer, Washington and Oregon in the Pacific region, or Alabama, the lowest.
- Match each service to its pricing unit. Budget 15-minute, per-session and per-assessment services separately.
- Build travel into community rates. The H2019 margin is wide, but rural travel is the largest hidden cost.
- Confirm the program chart. State Plan and 1115 waiver rates moved differently in 2026.
- Watch OPN 225041. Residential and stabilization rates may change again.
All 26,981 current Alaska Medicaid rates are available with a subscription; see pricing.
Rates are compiled from official Alaska Medicaid publications, including the Department of Health rate charts for community behavioral health, 1115 waiver services and psychiatric residential treatment, and each rate links to its source document. Rates published per 15-minute unit are converted to hourly figures by multiplying by four for ranking. Wages use federal occupational data for May 2025. The full Alaska fee schedule across all service lines is on the Alaska Medicaid rates page, and our methodology explains how hourly rates are derived and ranked.