Therapy Medicaid rates in Alaska are the highest in the country on almost every measure. Alaska Medicaid pays $176.68 an hour for physical therapy under code 97110, which ranks 1st of 49 states and sits 84% above the national median of $96.04. The rate is $44.17 per 15-minute unit, effective 2026-07-01.
That lead is not confined to one discipline. Alaska ranks 1st on physical therapy, occupational therapy and all three evaluation types, and 2nd on speech-language therapy. No other state comes close to that sweep. All figures here are compiled from official Alaska Medicaid publications, and the Alaska Medicaid rates hub links each rate to its source document.
Alaska Medicaid therapy reimbursement by service
Every therapy rate on the Alaska schedule shares the same effective date, 2026-07-01, which makes the comparison clean: there is no mix of old and new editions.
| Service | Code | Alaska rate | Rank | vs national median |
|---|---|---|---|---|
| Physical therapy | 97110 | $176.68/hour | 1 of 49 | +84.0% |
| Occupational therapy | 97533 | $338.72/hour | 1 of 48 | +206.3% |
| Speech-language therapy | 92507 | $118.16 | 2 of 39 | +91.7% |
| PT evaluation | 97162 | $149.65 | 1 of 46 | +83.1% |
| OT evaluation | 97166 | $153.02 | 1 of 46 | +85.7% |
| Speech-language evaluation | 92522 | $173.26 | 1 of 44 | +89.7% |
For a PT practice, the 97110 rate means each billed hour of therapeutic exercise brings in close to twice what a typical state pays. The evaluation codes follow the same pattern, so a new-patient episode in Alaska starts from a higher base than anywhere else.
The occupational therapy outlier: 97533 at $338.72 an hour
The single most unusual number on the Alaska sheet is occupational therapy. Code 97533 pays $84.68 per 15 minutes, which converts to $338.72 an hour. That is 206.3% above the national OT median of $110.60, and far ahead of the next states on the list: New Mexico at $198.64 and Montana at $197.20.
The gap means OT in Alaska should be modeled separately from PT rather than assumed to track it. In most states, the two disciplines sit within a similar band. In Alaska, an hour of sensory integrative work under 97533 pays nearly twice the state's own 97110 hour. Practices that staff occupational therapists for pediatric caseloads will see that difference flow straight into revenue per visit.
Speech therapy and evaluations
Speech-language therapy is the one service where Alaska is not first. Its $118.16 rate for 92507 ranks 2nd of 39 states, behind Washington at $144.10 and ahead of Arizona at $109.12 and Texas at $107.78. The rate is still 91.7% above the $61.64 national median.
Evaluations are where Alaska's lead is most consistent. The speech-language evaluation under 92522 pays $173.26, the top rate nationally and 89.7% above the $91.32 median. The OT evaluation ($153.02) and PT evaluation ($149.65) are also first. New Mexico is second on all three, which makes it the closest peer for an Alaska practice benchmarking its schedule.
Labor costs and margins for Alaska therapy providers
Alaska wages run above the national median for licensed therapists but not by the same margin as the rates. In May 2025, physical therapists earned a median $55.43 an hour in Alaska against $49.40 nationally. Occupational therapists earned $49.85 against $48.24, and speech-language pathologists $49.36 against $47.05.
Assistant wages split. Physical therapist assistants earned $37.33 against $32.88 nationally, while occupational therapy assistants earned $25.74, below the US median of $34.76.
Set against the Medicaid rates, that produces unusually wide margins:
- Physical therapy (97110): wages take 44.6% of the $176.68 hourly rate, leaving $97.90 an hour after a loaded wage.
- Occupational therapy (97533): wages take 20.9% of the $338.72 hourly rate, leaving $267.87 an hour after a loaded wage.
Those margins still have to cover travel, documentation, non-billable time and the cost of serving remote communities, which is significant in Alaska. But the starting point is stronger than in any other state.
Prior authorization and coverage rules
The coverage rules on file for Alaska are light. None of the eight therapy codes listed, 92507, 92521, 92522, 92523, 92524, 97110, 97112 and 97161, carries a prior-authorization rule or a unit limit. For billing staff, that means the Alaska fee schedule itself is the main constraint to track, rather than a stack of per-code authorization requirements.
How Alaska pays for therapy: fee-for-service, not managed care
Alaska Medicaid runs on fee-for-service. The payers named on file are Alaska Medicaid itself, covering all enrollees under fee-for-service, and Denali KidCare, the state's CHIP program. Our data records 3 plans in total and no managed-care service-line rule for therapy, so the published Alaska Medicaid fee schedule is the rate that applies to a therapy claim. The Alaska managed-care page lists the payers on file.
Recent changes to Alaska therapy rates
Two recent items shape the current schedule. The therapy fee schedule edition effective 2026-07-01, published as SFY27_Therapies.xlsx on 08/19/2026, changed rates by 1.66%. Separately, CMS approved Alaska SPA AK-26-0007 on 2026-09-04, with the same 2026-07-01 effective date. Practices that billed July and August claims before the edition was published should check whether those claims were paid at the new rates.
Alaska versus the highest and lowest therapy states
At the top of the physical therapy table, Alaska ($176.68) leads New Mexico ($165.64), Montana ($147.04), Texas ($135.00) and North Dakota ($129.16). At the bottom, New Jersey pays $58.80, California $48.88 and Maine $46.64, so the Alaska hour is worth several times the lowest-paying state's.
For multi-state therapy groups, Alaska is the ceiling, not a benchmark. The national therapy rates hub puts every state on the same basis, and our methodology explains how time-based codes are converted to hourly rates and ranked.
Updated 2026-10-05