Home care Medicaid rates in Alaska sit well above the national middle. Alaska Medicaid pays $9.30 per 15 minutes for personal care on T1019, which works out to $37.20 an hour. That ranks 7th of 27 states with a comparable hourly rate and is 21.9% above the national median of $30.52.
The pattern holds across respite, where Alaska pays above the median by an even wider margin, especially for full-day respite. For a personal care or attendant agency, Alaska is one of the few states where the published rate leaves room for a wage that competes in a high-cost labor market, and its annual July 1 rate cycle gives agencies a predictable update to plan around.
Personal care in Alaska is paid under the Alaska Personal Care Services and Community First Choice program, run by Senior and Disabilities Services. The T1019 rate of $9.30 per quarter hour has been effective since July 1, 2026.
At 7th of 27, Alaska trails only a short list of states. Utah leads at $84.84 an hour on S5125 and is an outlier on its own; Oregon is next at $42.24. Excluding Utah, Alaska sits close to the top of the range. At the other end, Texas pays $18.28 an hour on T1019.
For a multi-state operator, the same hour of personal care is paid very differently depending on which side of the national median a state falls, and Alaska is firmly on the high side. That does not make Alaska an easy market; it makes it one where the rate is designed to carry higher local costs.
Alaska Medicaid home care reimbursement is strongest for respite, and the daily rate stands out most.
| Service | Code | Alaska rate | Rank | vs national median |
|---|---|---|---|---|
| Personal care (hourly) | T1019 | $37.20 / hour | 7 of 27 | +21.9% |
| Respite (hourly) | S5150 U2 | $33.56 / hour | 10 of 38 | +32.6% |
| Respite (daily) | S5151 | $470.29 / day | 7 of 34 | +94.2% |
All three rates took effect on July 1, 2026, so they reflect the latest rate chart rather than an older schedule. The full dataset holds all 26,981 current Alaska Medicaid rates, each linked to its source on the Alaska Medicaid rates hub.
Alaska does not publish home care rates in one schedule. It uses separate rate charts, each tied to a program:
- Chart of Personal Care Services and Community First Choice Services Rates. This carries T1019 personal care and the attendant care rate used under Community First Choice.
- Chart of Waiver Services Rates. This covers services in the Alaska 1915(c) home and community-based waivers, such as respite and adult day.
- Chart of Long-Term Services and Supports Targeted Case Management Services Rates. This covers case management for people receiving long-term services.
Each chart is reissued for a state fiscal year starting July 1. A billing team should check that claims for dates of service after July 1 use the new chart's rate, and that claims for earlier dates still use the prior year's rate.
Hourly respite on S5150 pays $8.39 per 15 minutes with the U2 modifier, or $33.56 an hour, against a national median of $25.30. That places Alaska 10th of 38 states. Virginia leads the hourly ranking at $74.04.
Daily respite on S5151 is $470.29, 94.2% above the national median of $242.21. Only a handful of states, led by Minnesota at $938.09, pay more. For an agency that can staff overnight or extended respite blocks, the daily rate is the most generous home care line Alaska publishes.
The daily rate changes how respite should be planned. A 24-hour respite block at $470.29 supports overnight staffing, shift handoffs and travel to remote locations far better than a series of hourly visits would. Agencies serving families who need a weekend or multi-day break have a real reason to build that capacity.
Adult day services
Adult day services are paid on S5100 at $8.51 per 15 minutes, or $34.04 an hour. Because most states pay adult day as a daily rate, this one is not ranked against the national daily median of $68.67. The coverage rules list a daily limit on S5101, the daily adult day code, with no prior authorization rules attached.
Alaska's labor costs are higher than the national figures, so the above-median rate is partly absorbed by wages. The state median wage for home health and personal care aides was $19.11 an hour in May 2025, against a US median of $17.21. Registered nurses, whose time is needed wherever aide supervision is required, had a state median of $52.64 against $46.90 nationally.
Set against the published rates:
- Personal care at $37.20 an hour. The median aide wage is 73.0% of the rate, leaving a margin of $10.04 an hour after a loaded wage.
- Hourly respite at $33.56. The wage share rises to 80.9% and the margin falls to $6.40 an hour.
Personal care carries the stronger hourly margin, while hourly respite is thinner. An agency that offers both can lean on daily respite blocks, where the rate is far above the median, to improve the blend.
Costs the margin has to cover
The margin after loaded wages is not profit. In Alaska it has to pay for nurse supervision at above-national wages, travel across long distances, training, scheduling, billing and insurance. Agencies serving rural or road-off communities should model travel time explicitly, because a visit that takes an hour to reach can erase the margin on the visit itself.
Alaska updates its home and community-based rate charts on a July 1 cycle, and the 2026 round raised home care rates across the board.
- The Chart of Personal Care Services and Community First Choice Services Rates FY27 took effect July 1, 2026 with a 3.22% increase. This chart carries the T1019 personal care rate.
- The Chart of Waiver Services Rates FY27 applied a 3.2% increase from the same date, covering waiver services such as respite and adult day.
- The Chart of Long-Term Services and Supports Targeted Case Management Services Rates FY27 also rose 3.2%.
- The state published the 2026 Annual Rate Update notice of State Plan Amendment on June 30, 2026, and CMS approval of Alaska SPA AK-26-0007 followed on September 4, 2026, with a July 1, 2026 effective date.
Three years of increases
The FY27 increase follows a 3.2% increase in the FY26 charts effective July 1, 2025, and a 7.1% increase in the FY25 charts effective July 1, 2024, which combined 3.2% inflation with a 3.9% legislative adjustment. Rates have moved together across personal care, waiver services and case management, so no single home care line has fallen behind the others.
Alaska Medicaid covers its enrollees fee-for-service, and the plans on file are Alaska Medicaid itself and Denali KidCare CHIP. There is no managed-care layer negotiating home care rates, so the published rate charts are the rates agencies are paid.
That has practical consequences. Revenue forecasting is simpler, because there is one rate per service rather than a different rate per plan. Credentialing and contracting work is lighter. But an agency cannot negotiate a better rate for a hard-to-serve region; the only route to a higher rate is the state's annual update. The Alaska managed care page shows how the state's payment structure is set up across service lines.
Nationally, home care rates are compressed: most states pay personal care within a few dollars of $30.52 an hour. Alaska is one of the states that breaks above that band without reaching Utah's outlier. Oregon, the second-highest personal care state, pays $42.24 against Alaska's $37.20; Texas, the lowest, pays $18.28.
For respite, Alaska lands in the top third on the hourly rate and the top tier on the daily rate. Few states combine an above-median personal care rate with a daily respite rate this high, which makes Alaska a relatively well-funded home care market by Medicaid standards, offset by a higher local wage. Compare Alaska against every state on the home care Medicaid rates by state page, or against a neighbor such as Washington.
- Budgeting. Plan each fiscal year from July 1. Alaska's recent pattern of annual chart updates gives a reasonable basis for planning, but build budgets on the published chart, not on an assumed increase.
- Service mix. Personal care and daily respite carry the strongest economics. Hourly respite is viable but thinner.
- Wage setting. With a $10.04 margin per hour on personal care at the median wage, agencies have some room to pay above the median to recruit, but every dollar above it comes straight out of that margin.
- Billing. Use the U2 modifier where the waiver chart requires it for hourly respite, and keep daily and hourly respite on separate codes.
Rates are compiled from official Alaska Medicaid publications, including the Chart of Personal Care Services and Community First Choice Services Rates and the Chart of Waiver Services Rates for FY27. Each rate links to its source document. Rankings compare the rate for the same service across states that publish one, using the per-hour figure where a service is billed in time units. Wages are May 2025 medians. Rankings follow our methodology; access to the full dataset is described on our pricing page.