State License Applications for
Health Facilities
The document below provides links and other vital information for those who are interested in becoming Medicare & Medicaid participates.
License Fee Schedule
| Provider Type |
Provisional |
Biannual Renewal |
| Hospital |
$2,000 + $85/bed |
$4,000 + $170/bed |
| Nursing Home |
$1,000 + $125/bed |
$2,000 + $250/bed |
| Ambulatory Surgical Center |
$650 |
$1,300 |
| Free-Standing Birth Center |
$250 |
$500 |
| Home Health Agency |
≤ 5 FTEs: $1,000;
6-15 FTEs: $1,500;
16-50 FTEs: $2,000;
≥ 51 FTEs: $3,000;
+ $500 per branch/subunit |
≤ 5 FTEs: $2,000;
6-15 FTEs: $3,000;
16-50 FTEs: $4,000;
≥ 51 FTEs: $6,000;
+ $1,000 per branch/subunit |
| Volunteer Hospice |
$100
+ $100 per each additional
branch/subunit |
$200
+ $200 per each additional branch/subunit |
| Non-Volunteer Hospice |
$250
+ $100 per each additional branch/subunit |
$500
+ $200 per each additional branch/subunit |
| Inpatient Hospice Facility |
$250 + $75/bed
+ $100 per each additional branch/subunit |
$500 + $150/bed
+ $200 per each additional branch/subunit |
| Frontier Extended Stay Clinic |
$250 + $100/bed |
$500 + $200/bed |
License Applications
Did You Know?
State licensed facilities who are accredited by a nationally recognized organization may be eligible to waive the biennial State licensing survey during the current/upcoming licensing period. To review related regulations for survey waivers, see
7 ACC 12.925 and
AS 47.32.030(a)(9)(A-C).
If you have any questions, contact us at 907-334-2483.
State Licensure Modification Application
Modification ApplicationThis application should be utilized when changing information or services on a previously approved licensure application.
Ambulatory Surgical Centers (ASC)
Free-Standing Birth Centers
Rural Health Clinics (RHC) / Frontier Extended Stay Clinics (FESC)
Home Health Agencies (HHA)
Hospice Agencies
Hospitals (This application applies to all hospitals including General Acute Care, Rural Primary Care, Critical Access, Long Term Acute Care, and Specialized Hospitals.)
Nursing Homes (LTC) (New facilities must complete the LTC Application AND the Initial LTC documents located below. Facilities that are renewing their bi-annual license are only required to complete the LTC Application.)
LTC Application
State License Fees - Please review the following memorandum from the Office of the Lieutenant Governor regarding the adoption of new licensing fees for health facilities in Alaska. The effective date for the new licensing fees was June 29th, 2017.
Licensing Fees Memorandum