On May 28th, Alaska’s Medical Services Review Committee (MSRC) began its review for the 2027 workers’ comp fee schedule, signaling potential updates across pharmacy, DME, physical therapy, and ancillary services. Healthesystems attended the meeting, and while no recommendations were finalized, the Committee addressed several areas for review.

As this fee schedule progresses, it could lead to changes to pharmacy, DME, physical therapy, and ancillary reimbursement, and as a result could impact pricing, billing requirements, and utilization controls. The scope of topics suggests Alaska may pursue clarification and cost-containment updates as proposals advance. 

Pharmacy and Prescribing Controls

• Pricing variability, potential prior authorization, ingredient limits, and refill controls for compounded and topical drugs
• Requirements for the use of original NDCs, pricing transparency, reimbursement rules, and dispensing/billing requirements for repackaged and physician-dispensed drugs
• Potential evaluation of morphine milligram equivalent thresholds and prescribing guardrails for opioids

Physical Therapy and Therapeutic Monitoring

• Clarification of CMS-based multiple procedure reduction methodology for physical therapy
• Concerns about potential overlap with in-person therapy and related documentation requirements for remote therapeutic monitoring

DME and Ancillary Services

• Rental-to-purchase rules, automatic resupply, and clarification of fee schedule language for DME and supply items without an RR modifier
• High-cost acoustic medical devices to be billed under miscellaneous DME codes, including FDA status, rental vs. purchase, and accessory/supply costs
• An absence of a defined reimbursement methodology for ground ambulances
• The need for standardized reimbursement for telephonic, in-person, and ASL interpreter services
• Pricing variability and lack of benchmarks for newer timed codes for audiology/hearing aids

Fee schedule structure

• Potential incorporation of ongoing CMS updates and status indicators

RefMed, which supports the Committee in developing fee schedule policy, will further evaluate these issues, including benchmarking against other states, as it prepares recommendations for the 2027 fee schedule. The next MSRC meeting is scheduled for June 26, 2026.