IDD Medicaid rates in Alaska sit near the top of the country on almost every service. Alaska Medicaid pays $15.46 per 15 minutes for in-home and community living supports on code T2017, which is $61.84 an hour. That ranks 4th of 29 states and is 77.1% above the national median of $34.92.
Few states rank this high so consistently. Alaska is in the top five for community living supports, prevocational services, behavior support and residential habilitation, and in the top third for day habilitation. Every rate on this page took effect on 2026-07-01, so the schedule reflects the current state fiscal year. Rates are compiled from official state Medicaid publications, and each one links to its source document.
| Service | Code | Alaska per hour or day | Rank | vs national median |
|---|---|---|---|---|
| Community living supports | T2017 | $61.84 / hour | 4 of 29 | +77.1% |
| Day habilitation | T2021 | $43.64 / hour | 9 of 32 | +88.6% |
| Prevocational services | T2019 | $49.32 / hour | 4 of 28 | +164.2% |
| Supported employment | T2019 | $49.32 / hour | 11 of 39 | +20.8% |
| Behavior support | H2011 | $136.52 / hour | 4 of 23 | +74.9% |
| Residential habilitation | T2016 | $483.15 / day | 5 of 31 | +72.4% |
The table shows the six services most Alaska IDD agencies bill. Read it as a profile rather than a list: four of the six sit in the top five nationally, and none falls below the national median. That is unusual. In most states a provider finds one or two well-paid services next to others that barely cover staff time, and the business model bends toward whatever pays. In Alaska the schedule is high across the board, so the mix of services an agency offers can follow the needs of the people it serves rather than the rate schedule.
These figures are a small slice of the full Alaska schedule. All 26,981 current Alaska Medicaid rates, including every waiver modifier and provider type, are available with an account.
Alaska's IDD services are billed through the Alaska 1915(c) home and community-based waivers run by Senior and Disabilities Services. A 1915(c) waiver lets a state pay for community services that would otherwise only be covered in an institution, so the services on this page exist because the waiver defines them, and the rates come from the waiver rate chart rather than the physician fee schedule.
Units and the hourly conversion
Most hourly IDD services in Alaska bill in 15-minute units. T2017 at $15.46 per unit becomes $61.84 an hour; H2011 at $34.13 becomes $136.52. Residential habilitation on T2016 is the exception: it pays a single daily rate of $483.15, so it is compared per day. Our methodology explains how 15-minute units are converted to hourly figures so states with different unit conventions can be compared fairly.
Modifiers that change the meaning of a code
Modifiers matter in Alaska because two services can share one code. Day habilitation bills on T2021 with an HQ modifier, behavior support on H2011 with a CG modifier, and T2019 carries either TT or HQ depending on whether the service is prevocational or supported employment. A claim with the wrong modifier may still pay the same amount, but it is reported against the wrong service, which can matter in an audit or a plan-of-care review.
Prevocational services and supported employment both bill on T2019 at the same $12.33 per 15 minutes. The identical rate lands very differently against the rest of the country. Nationally, prevocational services carry a median of only $18.67 an hour, so Alaska's $49.32 is 164.2% above it, the widest gap of any Alaska IDD service. Supported employment has a higher national median of $40.84, so the same dollar figure is only 20.8% above the middle and ranks 11th of 39.
For a provider, this means the incentive structure common elsewhere is muted in Alaska. Many states pay job coaching far better than prevocational work, which pushes agencies toward community employment. In Alaska the two pay the same per hour, so the choice between them rests on the person's goals and on staffing logistics. The practical difference is cost: job coaching often happens one-to-one at an employer's site, while prevocational groups can share a staff member, so the same $49.32 an hour covers more people in a group setting.
At $61.84 an hour, one hour of community living support in Alaska pays more than in all but three ranked states. Only South Carolina ($85.96), South Dakota ($69.28) and Massachusetts ($68.04) pay more, and Alaska is just ahead of Maryland at $61.32. See the full state comparison on the T2017 code page.
Community living supports are usually delivered one-to-one in a person's home or out in the community, so the hourly rate has to cover the whole cost of a worker's hour plus everything around it: travel time between visits, documentation, supervision, training and the agency's overhead. In a state with long distances between clients, travel is a real cost that the rate does not price separately. A rate this far above the median gives agencies room to absorb drive time and still pay competitively.
Day habilitation on T2021 pays $10.91 per 15 minutes, or $43.64 an hour, 88.6% above the $23.14 national median and 9th of 32 states. Because day programs usually staff one worker to several participants, an hourly rate at this level supports smaller groups than states paying near the median.
Behavior support on H2011 pays $34.13 per 15 minutes, or $136.52 an hour. That puts Alaska 4th of 23 states, behind Maryland ($173.04), New Hampshire ($167.32) and Kentucky ($160.96), and far above the bottom of the range, where Idaho pays $24.64.
Behavior support is clinician-led work: assessing behavior, writing a support plan and training direct support staff and families to carry it out. The hourly rate has to cover a credentialed professional's time rather than a direct support wage, which is why it sits far above the T2017 rate. For Alaska agencies the rate is strong enough to justify employing behavior specialists rather than contracting them by the hour, which tends to help continuity for the people receiving support.
Residential habilitation on T2016 pays $483.15 a day, 5th of 31 states and 72.4% above the $280.27 national median. The four states above Alaska are Minnesota ($999.00), the District of Columbia ($567.62), New York ($564.22) and Oregon ($503.86). At the other end, Iowa ($140.81), Illinois ($108.00) and Oklahoma ($88.66) pay a fraction of Alaska's daily rate.
Reading a daily rate
A daily residential rate is a different budgeting problem from an hourly one. The provider is paid a fixed amount per person per day and must staff the home around the clock, so the economics depend on how many residents share a home and how many staff each shift needs. A home with higher support needs may need awake overnight staff; a home with more independent residents may not. The same $483.15 can therefore produce very different results in two homes.
ICF/IID
Alaska also publishes an ICF/IID rate of $769.80 a day, effective 2026-07-01. It is not ranked against other states, but for context the national ICF/IID median is $464.88, with the District of Columbia at $1,021.84 at the top and Oklahoma at $174.35 at the bottom. ICF/IID facilities are institutional settings with nursing and active treatment requirements, so their daily rate is not directly comparable with waiver group homes.
Alaska's high rates are paired with higher wages, though the wage gap is far smaller than the rate gap. Federal occupational data for May 2025 shows:
- Direct support professional: $22.77 in Alaska vs $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $22.20 vs $20.31
- Home health / personal care aide: $19.11 vs $17.21
- Licensed practical nurse: $38.85 vs $30.96
On community living supports, the median direct support wage of $22.77, once loaded with payroll taxes and benefits, takes 50.9% of the $61.84 hourly rate. That leaves $30.36 an hour for supervision, training, travel, administration and margin. On supported employment, the same loaded wage takes 63.8% of the $49.32 rate and leaves $17.84 an hour.
For most IDD providers in other states, the rate is the binding constraint on staffing. In Alaska, the T2017 rate leaves more room than in almost any other state, so the practical limits are more likely to be recruiting and travel distance than the hourly rate itself. That room is also what lets an agency pay above the median wage to win staff in a tight labor market.
Alaska's IDD waiver services are paid on a fee-for-service basis. The state's plan listings name Alaska Medicaid (all enrollees, FFS) and Denali KidCare CHIP rather than private managed-care organizations, and the IDD listings count 3 plans. In practice this means the published rate is the rate a provider is paid, without a separate plan negotiation. More detail is on the Alaska managed care page.
That simplicity has two consequences. First, there is no contract to negotiate: an agency cannot bargain a higher rate for complex clients through a plan, so cost differences must be handled through the service authorization itself. Second, the schedule is transparent. Every Alaska provider of a given service is paid the same published amount, which makes the rate a reliable basis for multi-year planning.
Prior authorization and limits
Our coverage records show no prior authorization rules attached to H2011, T2016 or T2017, and no unit limits. Service amounts are still governed by each person's plan of care under the waiver, so the real cap on billable hours is the authorized plan rather than a code-level limit.
The most important recent change for Alaska IDD providers concerns residential services. The state adopted and filed regulations on Medicaid coverage and payment for specialized group home and family home habilitation services (OPN 225015), published 2026-09-03 and effective 2026-10-02. That follows the notice of proposed changes to the same services (OPN 223715), published 2026-05-01.
Group home operators billing T2016 should compare the adopted text with their current service authorizations, since the change touches both coverage and payment for these services. Practical steps:
- Check whether service definitions or eligibility for specialized homes changed, and whether existing residents' authorizations still match.
- Confirm which claims dates fall before and after 2026-10-02 so billing uses the correct rules.
- Watch for updated rate charts that follow the regulation.
Alaska's position is clearest against the bottom of the range. Its $61.84 community living supports rate compares with $15.44 in Idaho, $13.52 in West Virginia and $12.40 in Louisiana. Its prevocational rate of $49.32 is behind only Oregon ($74.31), Minnesota ($69.42) and Utah ($60.68), while California, Indiana and the District of Columbia pay between $3.95 and $7.23 an hour.
The comparison is useful beyond curiosity. Agencies that operate in several states, or that are considering expansion, can see that an Alaska program built around community living and behavior support earns well above what the same model would earn in most of the country. Alaska does not publish a rate for community integration services in our data, so those services do not appear in its rankings. For the full national picture, see the IDD rates by state hub.
The published rate is the starting point for three practical decisions.
- Budgeting. Multiply authorized units by the rate for each service, then subtract the loaded wage cost. The $30.36 left per T2017 hour has to fund everything other than direct wages, including travel, so model drive time explicitly.
- Service mix. Because prevocational and supported employment pay the same hourly amount, compare them on staffing ratio and support needs rather than rate.
- Wage setting. With the direct support wage at 50.9% of the T2017 rate after loading, there is measurable room to raise pay. Test raises against the supported-employment margin, which is thinner at $17.84 an hour.
Related Alaska services sit on other pages: personal care on T1019 is covered on the Alaska home care rates page, and the full state schedule is on the Alaska Medicaid rates page.
Rates on this page are compiled from official state Medicaid publications for the Alaska 1915(c) home and community-based waivers run by Senior and Disabilities Services, and each rate links to its source document. Hourly figures are derived from the published 15-minute unit; daily rates are shown as published. National medians and ranks compare agency-provider rates for the same service across every state that publishes one. Wage figures are May 2025 federal occupational medians. See methodology for details and pricing for access to every current Alaska rate.