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Updates and reminders
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Effective in June 2024, the CMS PERM audit review contractor, Empower AI, Inc., will request medical records from providers whose Medicaid or CHIP Fee-for-Service claims are randomly chosen for review.
If one or more of your claims is chosen, you’ll receive a letter from the Kansas Department of Health and Environment (KDHE). You’ll receive actual medical records requests from NCI, Inc. at your office. KDHE staff can answer questions and help you meet submission deadlines.
We encourage you to learn more about the PERM program so you’ll know what to expect during the medical records request process. You can review the material on the CMS Provider website.
Here are some materials you can download as well as other helpful links:
Materials
PERM overview for providers (PDF): This PDF provides an overview of the PERM program, a better understanding of the process and what providers need to complete a successful PERM review. It also includes provider responsibilities, medical record and documentation requests as well as information for Provider Best Practices: prior to submitting records, when submitting records, when responding to additional documentation requests, and preventing resubmission.
PERM Initial Request for Records Example Letter Packet (PDF)
PERM initial ADR example letter packet (PDF)
PERM provider education FAQs (PDF)
2022 PERM claim category matrix (PDF)
Helpful links
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2024
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Mental Health Crisis Intervention (PDF)
Expansion of Providers for Psychosocial Rehabilitation (PSR) (PDF)
UPDATED - KBH Provider Payment Increase - Select Providers and Codes (PDF)
UPDATED - Place of Service Codes for Use in AuthentiCare (PDF)
Coverage of Attended and Unattended Sleep Studies (PDF)
HCPCS Changes - July 2024 (PDF)
KanCare All MCO HCBS 2024 Virtual Training Sessions (PDF)
Rate Increase for Family Training and Counseling Services (PDF)
Coverage of Individualized Custom Bath/Shower Chairs (PDF)
Append Modifier U1 to S0315, FE Telemonitoring Installation (PDF)
Upcoming EVV Town Hall Meetings (PDF)
HCBS Settings Ongoing Monitoring and Compliance (PDF)
Hospice Room and Board Reimbursed at 100% of Nursing Facility Rate (PDF)
Coverage of CPAP and BiPAP (PDF)
KBH-EPSDT Blood Lead Screening Questionnaire Form (PDF)
Autism Codes - CCTS/IIS Coverage (PDF)
Coverage of CPAP and BiPAP (PDF)
Hospice Room and Board Reimbursed at 100% of Nursing Facility Rate (PDF)
Immunization Administration by Pharmacy Providers (PDF)
Global Pregnancy Services (PDF)
Updated Criteria Guidance for Coverage of Insulin Infusion Pumps and Supplies (PDF)
Prior Authorization Updates (PDF)
Reminder - Solicitation by Medical Equipment Suppliers (PDF)
HCBS Rate Changes for Fiscal Year 2025 (PDF)
Wheelchair Cushion Coverage (PDF)
Place of Service Codes for Use in AuthentiCare (PDF)
Preferred Drug List Update (PDF)
UPDATED - Rate Changes for Physician Administered Drugs – April 2024 (PDF)
CCBHC Specialty Designation for PPS - Service Code Additions - Supported Housing (PDF)
Coverage of Diabetes Devices, Accessories, and Supplies Update (PDF)
Doulas Enrollment and Coverage (PDF)
Ordering or Referring NPI - Enrollment Type Requirements (PDF)
CMS PERM Program Review Process (PDF)
HCPCS Changes – April 2024 (PDF)
Revised Anesthesia Conversion Factors for Calendar Year 2024 (PDF)
KanCare All MCO 2nd Quarter 2024 Virtual Training Sessions (PDF)
Preferred Drug List Update (PDF)
Immunization Administration by Pharmacy Providers (PDF)
Code B9998 to be Manually Priced (PDF)
Documentation for Dressings and Supplies (PDF)
Preferred Drug List Update (PDF)
UPDATED - Rate Changes for Physician Administered Drugs – April 2024 (PDF)
E/M Modifier 25 Use with KBH Vision Code 99173 (PDF)
Updated ADA Dental Claim Form Guidance (PDF)
Prior Authorization Updates (PDF)
Rate Changes for Physician Administered Drugs – April 2024 (PDF)
PD Waiver - PCS in Congregate Settings (PDF)
2024 AuthentiCare Training Sessions (PDF)
Change Healthcare Outage Continues (PDF)
PRTF Clinical Requirements (PDF)
Residential Services IDD Married Couples (PDF)
HCBS PCS in Congregate Settings Exempt from EVV Requirement (PDF)
NCCI/MUE Editing - April 2024 (PDF)
Coverage Change for Injectable Triamcinolone Acetonide (PDF)
MS-DRG Update for April 2024 (PDF)
UPDATED - Reminder of Guidance on Electronic Visit Verification (EVV) Requirements (PDF)
PRTF Clinical Requirements (PDF)
ADAPD Claims Processing Point of Contact (PDF)
Adjunctive Subcutaneous Continuous Glucose Monitors (PDF)
EVV Town Hall: Update and Open Forum (PDF)
All MCO 1st Quarter Virtual Training - Home Health (PDF)
UPDATED Change Healthcare Outage (PDF)
Deactivation of MUE Editing for BI Waiver Codes 97535 and 97537 (PDF)
UPDATED Reminder on Guidance on Electronic Visit Verification (PDF)
Change Healthcare Outage (PDF)
Preferred Drug List Update (PDF)
UPDATED - Change Healthcare Outage (PDF)
KanCare All MCO 1st Quarter 2024 Virtual Training Sessions (PDF)
EVV Town Hall Update and Open Forum (PDF)
Cognitive Therapy CPT Code Change Clarification (PDF)
Update to Cognitive Therapy Code Change on the BI Waiver (PDF)
SOBRA Coverage for Approved Emergency Services (PDF)
Specialized Wheelchair Seating Assessment Centers Criteria and Application (PDF)
Preferred Drug List Update (PDF)
HCPCS Changes – January 2024 (PDF)
PACE Midland Care Connections County Expansion (PDF)
PACE Bluestem Reduction of Counties (PDF)
MediKan Claim Clarification - CCBHCs (PDF)
Home Administration Code M0201 Reimbursement (PDF)
TA Home Modification Limit Increase (PDF)
Stay Enrolled as a KanCare Provider – Don’t Forget to Revalidate (PDF)
RESCINDED - High Dollar Rare Disease Drug List February 2024 (PDF)
Provider Specialty Updates for CCBHC (PDF)
High Dollar Rare Disease Drug List February 2024 (PDF)
Private Rooms in Nursing Facilities and Intermediate Care Facilities (PDF)
Prior Authorization Updates (PDF)
POA Indicators on Swing Bed Nursing Facility Claims (PDF)
Cognitive Therapy Code Changes for the Brain Injury Waiver (PDF)
Electronic Visit Verification for In Lieu of Services (PDF)
EVV Town Hall: Update and Open Forum (PDF)
Testing/Scoring Service Codes for CMHCs (PDF)
Updates to the HCBS Provider Qualifications Audit Process (PDF)
Clarification of Allergy Immunotherapy Billing (PDF)
Adding New Provider Types and Specialties to PET Scans (PDF)
COVID-19 Test Kit Coverage Update - MCOs (PDF)
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2023
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Provider Bulletin Peer to Peer for Prior Auth Denials (PDF)
HCBS Provider Qualification Audit (PDF)
2023 Holiday Schedule Bulletin (PDF)
Provider Notice Retro Enrollment (PDF)
Provider Bulletin Improved Remit (PDF)
Progeny Health’s NICU Care Management and Utilization Review (PDF)
Provider Notification 21 code Changes from Prior Authorization (PDF)
Aetna Better Health® of Kansas EPSDT Medical Necessity Form (PDF)
Provider Bulletin Healthier Outcomes (PDF)
ABHKS Provider Bulletin_Continuity of Care, Member Record Documentation (PDF)
Notification of Pregnancy Provider Notification (PDF)
Code Removal Provider Notification (PDF)
Hep C and Prenatal Vaccines-Provider Bulletin (PDF)
Holiday Check Run Labor Day (PDF)
Provider portal user guide (PDF)
EFT ERA Process - Provider communication (PDF)
Provider bulletin - Improved remit (PDF)
Provider bulletin - Polypharmacy (PDF)
The Early and Periodic Screening, Diagnostic, and Treatment (PDF)
Lead screening, childhood and adolescent immunizations (PDF)
Antibiotics (PDF)
Diabetes (PDF)
Prenatal-Postpartum Care (PDF)
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REMINDER: Community Health Worker Services - RHC/FQHC/IHC Providers
Adding AuthentiCare Coverage for EPSDT Services
Medicare Part D Copayment Assistance for 2024
Coverage of Bath and Toilet Aids
Incontinence Supplies in Quantities to Meet Members’ Needs
UPDATED - Mental Health Medication Emergency Supply
MS-DRG Update for January 2024
Medication Assisted Treatment Rate Update – January 2024
Subcutaneous Continuous Glucose Monitors
EVV Town Hall: Update on Go-Live and Open Forum
Removal of Fee-for-Service Copays
Preferred Drug List and Prior Authorization Updates
Sequestration Reduction – Certified Community Behavioral Health Clinics
Coverage for RSV Vaccines for Pregnant Women
Coverage for RSV Vaccines for Ages 60 and Older
UPDATED - High Dollar Rare Disease Drug List Q3 2023
NCCI/MUE Editing - January 2024
Non-Waiver Mental Health Attendant Care Service Code – EVV Implementation Resuming
UPDATED - High Dollar Rare Disease Drug Reimbursement
Coverage for Nirsevimab (Beyfortus)
Continued Stay Screen for Individuals Residing in NF/MH Denial Code
REMINDER – Provider Review of PDMP Annual Attestation Requirement - ONLINE Submission Only
UPDATED - Further Guidance on Electronic Visit Verification
HCBS Appendix K - COVID Measure Rescinding (PHE Changes Ending)
HCPCS Code Update – October 2023
WORK ILC and STEPS CSC Rate Change January 2024
COVID-19 Vaccines and Bivalent Discontinuation
Pharmacy Billing of Vaccines and Vaccine Administration Fees
Prevnar 20 Vaccine Coverage for VFC
Expanding Peer Support Providers
2024 Updates to the Medicare Guidelines for Unacceptable Principal Diagnosis Codes
Removal of Code Combinations for EVV HHCS Home Health Visits
Non-Waiver Mental Health Attendant Care Service Code
High Dollar Rare Disease Drug List Update
ORP NPI vs. Performing and Billing NPI
Fiscal Year 2024 Hospice Reimbursement Rates
HCBS Appendix K Member Underwriting Notice (PDF)
Annual Attestation Requirement
Over the Counter Rebate Eligible Naloxone
WORK ILC and STEPS CSC Rate Change
Addition of Place of Service Code 27
KanCare All MCO 4th Quarter 2023 Virtual Training Sessions
KDHE to Hold KanCare Re-Procurement Public Meetings
Children’s Behavioral Interventionist Program
Peri-partum Optimization Postpartum Visit Tag from OB Global Code
Rate Change for Physician Administered Drugs October 2023
Physician Services in a Hospital Setting
Further Guidance on Electronic Visit Verification
Physical Disability Waiver Crisis Exception Policy
Physician Services in a Hospital Setting
Hospice Recertification Documentation
MCO Pharmacy Point-of-Sale Contractual Write-off Pricing
Vision Allowable Places of Service
Diabetes Self-Management Training
Rate Increase for Lactation Counseling
UPDATED - Further Guidance on Electronic Visit Verification
UPDATED - Pharmacist as Provider - Approved Billable Services
EVV Vendor and Town Hall Opportunities
Rate Increase for Lactation Counseling
UPDATED - Further Guidance on Electronic Visit Verification
EP Modifier for EPSDT Medically Necessary Non-Covered Services
Further Guidance on Electronic Visit Verification
Provider Application Fee Change 2023
Allowance of POS Code 99 for IIS Providers
JG Modifier Reimbursement Rate
Addition of Autism Waiver Self-Directed Respite Services
NCCI MUE Editing - October 2023
Adding Services for AuthentiCare Coverage Non-Waiver Health Mental Health Attendant Care
Pharmacist as Provider – Approved Billable Services
EVV Vendor and Town Hall Opportunity
Pharmacy Immunization Administration
UPDATED Community Health Worker Services
Dental Providers Under Locum Tenens Agreements
Discontinuation of Janssen COVID-19 Vaccine
KanCare All MCO HCBS 2022 Virtual Training
KanCare All MO HCBS23 Virtual Training Invitation State Approved (PDF)
COVID-19 Monovalent and Bivalent Vaccine Updates (PDF)
Preferred Drug List Update. (PDF)
Adding Services for AuthentiCare Coverage Non-waiver Health Mental Health Attendant Care (PDF)
EVV Town Hall Opportunity (PDF)
Community Health Worker Services
Rate Increase for Physician Services per Legislative Allocation
Appeals of Administration Denials of Payment
Brain Injury Rehabilitation Facility FY24 Rate Change
UPDATED - I/DD TCM Rate Change
Annual DME Rate Adjustment and Medicare Fee Schedule Update
Discontinuation of Evusheld Coverage
Self-Monitoring Blood Pressure Devices Coverage
UPDATED Provider Review of PDMP - Attestation Requirement
Global Pregnancy Services Rate Increase
TPL Pay and Chase for Claims Billed by CCBHC
Reminders Regarding Provider Appeals and External Independent Third-Party
State Institution Alternative Hospitals Update
Coverage of Denture and Prosthetics for Ages 21 and Over
UPDATED Further Guidance on Electronic Visit Verification
Reminder - Solicitation by Medical Equipment Suppliers
REMINDER - Provider Appeals and External Independent Third-Party Review Requests
State Institution Alternative Hospitals Update
2023 Provider Bulletin - HCBS Provider Qualification Audit Process and Background Check Policy (PDF)
Ambulance Service and Ground Mileage Rate Increase with Rates (PDF)
CMS PERM Review Process (PDF)
Ninety Day Supply Maintenance _Drug List MCO Only UPDATED (PDF)
Rate Change for Physician Administered Drugs – July_2023 (PDF)
CCBHC Specialty Designation for Prospective Payment System Code Clarification (PDF)
Family Psychotherapy without Patient Present (PDF)
Discontinuance of Pharmacy Related COVID Policies (PDF)
Further Guidance on Electronic Visit Verification (PDF)
Application of Topical Fluoride Billing Claims Change (PDF)
Preferred Drug List Update (PDF)
Discontinued Telephonic Coverage of Select Speech Therapy Codes (PDF)
Discontinued Telephonic Coverage of CCTS and IIS Codes (PDF)
Provider Revalidation Reminder (PDF)
UPDATED - Adding Services for AuthentiCare Coverage – HCBS/SED Attendant Care (PDF)
REMINDER - Mental Health Medication Emergency Supply (PDF)
Important KMAP Portal Updates (PDF)
Preferred Drug List Update (PDF)
Application of Topical Fluoride Billing Claims Change (PDF)
Removal_of_Motor_Vehicle_Screens_for_Autism_Services (PDF)
TC_Rates_for_PET_Scans (PDF)
Working_Healthy_Premium_Recommendations (PDF)
MAT Injectable Products (PDF)
PRTF_Clinical Requirements (PDF)
Pharmacist Counseling Signature Log Retention Requirement. (PDF)
REMINDER 23071 - Provider Review of PDMP (PDF)
KanCare All MCO 2nd Quarter Virtual Training (PDF)
Revision_to_January_2022_MUE_DME_and_OPH_Files (PDF)
Adding_Services_for_AuthentiCare_Coverage_HCBS_SED_Attendant_Care (PDF)
Re Evaluation Cov Visual erage for Rehabilitative Physical and Occupational Therapy (PDF)
Retroactive_Eligibility_Claims_Processing (PDF)
ICD-10_Diagnosis Code_Updates_April_2023 (PDF)
Pfizer_COVID-19_Bivalent_Boosters_Update (PDF)
April_2023_Deactivation_of_NCCI_PTP_Edits (PDF)
Preferred_Drug_List_Update - April (PDF)
Coverage_of_Stand-Alone_Vaccine_Counseling (PDF)
Provider_Review_of_PDMP (PDF)
Medication_Assisted_Treatment_and_Office_Based_Opioid_Treatment_Programs_Update (PDF)
CCBHC_Code_Non-billable_in_a_PRTF_or_NFMH_Setting (PDF)
Services_Not_Covered_When_Billed_by_an_RHC_FQHC (PDF)
KMAP_Portal_Updates (PDF)
Eligibility_Redetermination (PDF)
Important_Provider_Secure_Portal_Update (PDF)
Prenatal_Care_at_Risk_Enhanced_Care_Coordination_Allowable_via_Telemedicine (PDF)
MS-DRG_Update_for_April_2023 (PDF)
Prior_Authorization_Updates (PDF)
Revalidation_Process_Reminder (PDF)
Important_Provider_Secure_Portal_Updates (PDF)
Preferred_Drug_List_Update (PDF)
Licensed_Mental_Health_Practitioner_Reimbursement_Guidelines (PDF)
Provider Application_Fee_Collection_Resumes (PDF)
Adding_Place_of_Service_Code_10_to_Home_Telehealth_Nursing_Services (PDF)
Discontinuation_of_Evusheld_Coverage (PDF)
Lactation_Counseling_Allowable_Via_Telemedicine (PDF)
HCBS_Final_Rule_Monitoring_and_Compliance (PDF)
Ordering_Referring_Prescribing_NPI_Requirements (PDF)
Age_Restriction_Removal_on_Influenza_Vaccine (PDF)
High_Dollar_Rare_Disease_Drug_Reimbursement_Update (PDF)
UPDATED_KanCare_All_MCO_First_Quarter_2023_Virtual_Training_Sessions (PDF)
HCBS_Final_Rule_Monitoring_and_Compliance (PDF)
UPDATED - Positron Emission Tomography (PET) Scan (PDF)
Discontinuation of Coverage for Bebtelovimab (PDF)
Peer Support Services Coverage Update (PDF)
KanCare All MCO First Quarter 2023 Virtual Training (PDF)
Rate Changes for Physician Administered Drugs – April 2023 (PDF)
COVID-19 Test Kit Additions (PDF)
Updates to the HCBS Provider Qualifications Audit Process (PDF)
Sterilization Consent Form Signatures (PDF)
HCPCS 2023 Updates (PDF)
COVID-19 Bivalent Vaccine Boosters Update (PDF)
Pharmacy Coordination of Benefits Contractual Write-Off - New NCPDP Payer Sheets (PDF)
Annual Attestation Requirement
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December 2023 Provider Newsletter (PDF)
November 2023 Provider Newsletter (PDF)
October 2023 Provider Newsletter (PDF)
September 2023 Provider Newsletter (PDF)
Q3 2023 Provider Newsletter (PDF)
August 2023 Provider Newsletter (PDF)
July 2023 Provider Newsletter (PDF)
June 2023 Provider Newsletter (PDF)
May 2023 Provider Newsletter (PDF)
April 2023 Provider Newsletter (PDF)
March 2023 Provider Newsletter (PDF)
February 2023 Provider Newsletter (PDF)
2022
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Improving Appropriate Use of Antibiotics (PDF)
Paper Remit Improved Design (PDF)
Holiday Check Run Schedule (PDF)
Dial “988” for the Suicide & Crisis Lifeline (PDF)
Appointment Availability Standards/ Telephone Accessibility Standards (PDF)
Update: Procedure Codes No Longer Requiring Prior Authorization (PDF)
Palliative Care 2022 ECHO (PDF)
Prior Authorization Change for Respiratory Panels (PDF)
Notification of Pregnancy Notice (PDF)
Bulletin - Notification of Pregnancy Form (PDF)
Aetna Better Health Town Hall Event (PDF)
Ground Mileage for Ambulance Transportation (PDF)
Procedure Codes No Longer Requiring Prior Authorization (PDF)
Appointment Availability Standards/Telephone Accessibility Standards (PDF)
Addition of Codes Requiring Prior Authorization (PDF)
New Prior Authorization Request Form (PDF)
Provider Town Hall Event (PDF)
Access and Availability Bulletin – Updated (PDF)
New Paper Claims Submission Address (PDF)
2022 Healthier Outcomes Program (PDF)
Reminder – Itemized Statements for Inpatient Hospital Admissions (PDF)
Chlamydia Screening in Women (PDF)
Provider Webinar on EPSDT Program (PDF)
Home and Community Based Services / Long Term Services and Supports Provider Town Hall Event (PDF)
Availity Prior Authorization Process (PDF)
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HCPCS E&M Code Update 2023 (PDF)
2023 Anesthesia Conversion Factor (PDF)
C-Code HCPCS 2023 Updates (PDF)
CCBHC Provider Type/Provider Specialty Designation and Place of Service (PDF)
KMAP Paper Check Payments Delayed (PDF)
Coverage Related to Weight Loss (PDF)
Rate Increase for Nursing Facility Ventilator Program (PDF)
Important KMMS Update: KMAP Provider Secure Portal Date of Service (PDF)
Provider Application Fee Change - 2023 (PDF)
Long-Acting Reversible Contraceptives Billing by an RHC/FQHC (PDF)
Home Health Care Services Electronic Visit Verification Compliance Deadline
Update (PDF)
Parent Peer Support (PDF)
Coverage of Outpatient Pulmonary Rehabilitation (PDF)
Positron Emission Tomography (PET) Scan (PDF)
Rate Changes for Physician Administered Drugs – January 2023 (PDF)
Coverage of Shingrix for Immunocompromised Ages 19 and Older (PDF)
KMAP Provider Group Affiliation Update (PDF)
MediKan Drug Coverage Update (PDF)
HRSA Medicaid Exclusions (PDF)
Long-Acting Reversible Contraceptive Billing Allowance – Post Partum (PDF)
NCCI/MUE Editing - January 2023 (PDF)
Medication Assisted Treatment Drugs/Biologicals - Rate Update -January 2023 (PDF)
UPDATED - High Dollar Rare Disease Drug Reimbursement (PDF)
RHC/FQHC Rate Changes –January 2023 (PDF)
Certificate of Medical Necessity Form for Oxygen is Discontinued (PDF)
Ostomy Products Coverage Update (PDF)
Medicare Part D Copayment Assistance for 2023 (PDF)
Preferred Drug List Update (PDF)
Bebtelovimab Rate Change (PDF)
Assurance of PRTF Per Diem Rate (PDF)
Swing Bed Rate for 2023 (PDF)
SFY 2022 Kansas Single State Audit Announcement (PDF)
Medicaid Rates for Physician Administered Drugs (PDF)
CCBHC Specialty Designation Service Code Update (PDF)
COVID-19 Novavax Vaccine Booster Update (PDF)
Corrected Fee Schedules Available (PDF)
SFY 2022 Kansas Single State Audit Announcement (PDF)
Medicaid Rates for Physician Administered Drugs (PDF)
CCBHC Specialty Designation Service Code Update (PDF)
COVID-19 Novavax Vaccine Booster Update (PDF)
Prior Authorization Updates (PDF)
MS-DRG Revisions for 2023 (PDF)
Important KMMS Update – Unit Type (PDF)
Coverage of Pneumococcal Conjugate Vaccine for Persons Under 19 Years of Age (PDF)
Important KMMS Update –Patient Liability Display (PDF)
HCAIP Adjustment Factor Removal (PDF)
KMMS/KMAP System Down Time (PDF)
COVID-19 Bivalent Vaccine Boosters Update (PDF)
90-Day Supply Maintenance Drug List (PDF)
Fiscal Year 2023 Hospice Reimbursement Rates (PDF)
UPDATED - Lactation Counseling (PDF)
UPDATED - External Independent Third-Party Review (PDF)
Update: KanCare All MCO 3rd Quarter 2022 Training Now All Virtual (PDF)
REMINDER Effective October 9, 2022 NCPDP Validation and Translation Error (PDF)
Billing Guidance for Spravato (PDF)
Prior Authorization Updates (PDF)
KanCare All MCO 3rd Quarter 2022 In-Person Training (PDF)
Novavax COVID-19 Vaccine Coverage (PDF)
CCBHC Specialty Designation for Prospective Payment System Updates (PDF)
Monkeypox Laboratory and Vaccine Coverage (PDF)
COVID-19 Bivalent Vaccine Booster (PDF)
Ending the COVID-19 Public Health Emergency Temporary Waivers (PDF)
Prior Authorization Updates (PDF)
Preferred Drug List Update (PDF)
Medicare Guidelines for Unacceptable Diagnosis Codes Update (PDF)
Medical Attestation Form Required for Clinical Trials (PDF)
Revisions to October 2022 NCCI PTP Editing (PDF)
Low Profile G-Tube Coverage Update (PDF)
Addendum to NEMT Services for Dental Procedures (PDF)
Hospice Service Provider Update (PDF)
HCAIP OPS Adjustment Factor Update (PDF)
New KMAP Portal Training Videos (PDF)
Additional Moderna COVID-19 Vaccines for Children (PDF)
Nursing Facility Provider Revalidation Notification Process (PDF)
HCAIP Inpatient Claims Update (PDF)
New KMAP Portal Training Videos (PDF)
UPDATED - NCPDP Validation and Translation Errors (PDF)
Nursing Facility Provider Revalidation Notification Process (PDF)
HCAIP Inpatient Claims Update (PDF)
COVID-19 Vaccines for Children Ages 6 Months to 5 Years (PDF)
Novavax COVID-19 Vaccine Coverage (PDF)
Pfizer Pediatric Vaccine Booster Dose (PDF)
Medicare Part C Verification Updates (PDF)
Preferred Drug List Update (PDF)
Program Integrity Spotlight (PDF)
DME Guidelines for Diabetic Supplies (PDF)
NEMT Provider and Driver Requirements Update (PDF)
COVID-19 Test Kit HCPCS Code Update (PDF)
Project Access Covid Tests (PDF)
Limitations for Maternal Depression Screenings Update (PDF)
Revision to July 2022 NCC I MUE Files OPH/PRA (PDF)
KMAP Paper Check Payments Delayed (PDF)
UPDATED - Behavioral Health Services Rate Increase (PDF)
Preferred Drug List Update (PDF)
KanCare All MCO HCBS 2022 Virtual Training (PDF)
UPDATED - Ambulance Service and Ground Mileage Rate Increase Update (PDF)
Services Performed by Temporarily Licensed SLPs Code Update (PDF)
Update to Dental Coverage for Ages 21 and Older (PDF)
Pregnant Woman Postpartum Coverage Extension (PDF)
Rate Increase for HCBS SED Services (PDF)
Addition of Autism Waiver Self-Directed Respite Services (PDF)
Behavioral Health Services Rate Increase (PDF)
Hospital at Home Care Code Update (PDF)
Annual DME Rate Adjustment (PDF)
Prior Authorization Updates (PDF)
COVID-19 Testing for Same Date of Service (PDF)
REMINDER - KMAP Recommended Browsers (PDF)
KMAP Provider Training Opportunities (PDF)
Pediatrician Rate Increase Update (PDF)
Ambulance Service and Ground Mileage Rate Increase Update (PDF)
High Dollar Rare Disease Drug Reimbursement (PDF)
Hospital Readmission Guidelines Update (PDF)
Place of Service Allowance for OneCare Kansas Codes (PDF)
NCCI-MUE Editing - July 2022 (PDF)
Coverage of Periodontal Maintenance (PDF)
Preferred Drug List Update (PDF)
UPDATED- Reminder- 340B Provider Claim Identification and Drug Rebate Invoicing Process Update (PDF)
Pediatric Dental Coverage Update (PDF)
NCPDP Common File Error Log (PDF)
NOTICE: KMMS Daily Maintenance (PDF)
CMS PERM Review Process Completed (PDF)
Additional KMAP Portal Training Videos (PDF)
KanCare All MCO Spring 2022 Virtual Training (PDF)
UPDATED - Reimbursement for Dispense as Written Approved Pharmacy Claims (PDF)
Sterilization Consent Form (PDF)
Coverage of Family Psychotherapy Without Patient Present (PDF)
Patient Costs Furnished with Participation in Qualifying Clinical Trials (PDF)
Reminder to MCO Providers Regarding External Independent Third-Party Review (PDF)
Coverage of Monoclonal Antibody Bebtelovimab (PDF)
REMINDER - KMAP Recommended Browsers (PDF)
HCPCS Update – April 2022 (PDF)
Pneumococcal Vaccine Coverage Update (PDF)
Evusheld™ Emergency Use Authorization Coverage for Ages 12 and Over (PDF)
Emergency Use Authorization Coverage for Evusheld™ (PDF)
COVID-19 Antiviral Coverage Update (PDF)
Mobile Crisis Intervention Services Provided by a CMHC or CCBHC (PDF)
MS-DRG Revisions for 2022 (PDF)
Reminder - NDC Billing Compliance (PDF)
New KMAP Portal Training Videos (PDF)
Updated Preparation for Rescheduled KMMS Go-Live April 4, 2022 (PDF)
Action Required by March 31, 2022 to Avoid KMAP Access Interruption (PDF)
Maternal Depression Screening Coverage Update (PDF)
Provider Review of the PDMP – Age Requirement Update (PDF)
COVID-19 Test Kit Coverage (PDF)
HCPCS Update Delay for 2022 (PDF)
ICD-10 Updates – April 2022 (PDF)
Reimbursement for Dispense as Written Approved Pharmacy Claims (PDF)
COVID-19 VEKLURY™ (Remdesivir) Antiviral Medication Coverage Update (PDF)
Coverage of Services Provided by Temporarily Licensed Speech and Language Pathologists (PDF)
Pharmacy 24-Hour Prior Authorization Requirements (PDF)
NCCI-MUE Editing – April 2022 (PDF)
Prior Authorization Updates (PDF)
COVID-19 VEKLURY™ (Remdesivir) Antiviral Medication Coverage (PDF)
Pfizer COVID-19 Pre-Diluted (Gray Cap) Vaccine Coverage (PDF)
Performing Provider Affiliation Project Completed (PDF)
KanCare All MCO First Quarter 2022 Virtual Training (PDF)
Preferred Drug List Update (PDF)
Third Dose of COVID-19 Vaccine for Immunocompromised Children (PDF)
Updates to the HCBS Provider Qualifications Audit Process (PDF)
The COVID-19 Public Health Emergency and Medicaid FAQs (PDF)
Conversion Factor for Anesthesia Codes Update (PDF)
24-Hour Prior Authorization Requirements (PDF)
Hospice Attending Physician Services for RHCs and FQHCs Update (PDF)
Revised Preparation for Rescheduled KMMS Go-Live April 4, 2022 (PDF)
COVID-19 Booster Vaccine Update (PDF)
REMINDER: Claim Filing Indicator Code for Medicare or Medicare Replacement Plan (PDF)
COVID-19 Moderna Low Dose Booster Update (PDF)
KMMS Go-Live: Implementation Date Change (PDF)
Actualización: ACTIVATION AND ENFORCEMENT OF WEDI SNIP LEVEL 1 & 2 COMPLIANCE EDITS (PDF)
Provider Review of the PDMP – Frequency Clarification (PDF) -
2021
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COVID-19 Temporary Changes in Prior Authorization Precertification (PDF)
Holiday Check Run Schedule (PDF)
Bulletin - Social determinants of health (PDF)
Provider Town Hall Event (PDF)
Provider Bulletin - Eviti Connect (PDF)
New Kansas Medicaid Modular System (PDF)
Availity Registration Update (PDF)
PERM Audit - Provider Medical Records Requests (PDF)
Update: Web Connect Tool Enhancement (PDF)
UPDATE: COVID-19 Communications (PDF)
Increase in Peer Support Reimbursement (PDF)
UPDATE: COVID-19 Communications (PDF)
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Dental HCPCS 2022 Updates (PDF)
COVID-19 Booster Vaccine Update (PDF)
New Place of Service Code 10 (PDF)
Pediatric COVID-19 Vaccine Coverage (PDF)
Provider Application Fee Change - 2022 (PDF)
RHC and FQHC Optometry Codes (PDF)
Medicaid Assisted Treatment Rate Update for January 2022 (PDF)
Conversion Factor for Anesthesia Codes Update (PDF)
Prior Authorization Updates (PDF)
Coverage of Varicose Vein Treatments (PDF)
Rate Increase for Global Pregnancy Services (PDF)
Additional COVID-19 Booster Vaccine Updates (PDF)
Updated Preparation for KMMS Go-Live January 2022 (PDF)
Daily Swing Bed Rates for Calendar Year 2022 (PDF)
Coverage for Low Dose Lung CT (LDCT) (PDF)
2022 MS-DRG Weights and Rates (PDF)
Final Opportunity Performing Provider Affiliation Project (PDF)
COVID-19 Booster Vaccine Update (PDF)
Coverage of Colorectal Screenings (PDF)
FY 2022 Hospice Payment Rates (PDF)
NCCI-MUE Editing - January 2022 (PDF)
Medicare Part D Copayment Assistance (PDF)
Place of Service Update for Mobile Crisis Intervention (PDF)
Spravato® Coverage Update (PDF)
MS-DRG Revisions for 2022 (PDF)
CMS Omnibus COVID-19 Vaccination Interim Final Rule (PDF)
Prescription Drug Monitoring Program Policy Clarifications (PDF)
Preferred Drug List Update (PDF)
Diagnosis Restriction for Code J3262 (PDF)
Single State Audit KMAP Provider Bulletin Notice 2021 (PDF)
Criteria Coverage for State Institution Alternative (PDF)
Addendum for Mileage Reimbursement Codes (PDF)
HCBS Military Inclusion Policy (PDF)
Addendum for Dental Codes D7961 and D7962 (PDF)
Revisions to NCCI Editing October 2021 (PDF)
New Forms Available Through Provider Enrollment (PE) Wizard (PDF)
KMAP Provider Enrollment System Upgrade (PDF)
HCPCS Changes – October 2021 (PDF)
October 2021 HCPCS Update (PDF)
UPDATED – Enteral Product and Physician Administered Drug Billing Guidance (PDF)
Coverage of Revenue Code 0220 (PDF)
Prior Authorization Updates (PDF)
Preferred Drug List Update (PDF)
Addendum to Rate Increase for COVID-19 Vaccine Administration in the Home (PDF)
Electronic Authorization Acceptance Now in AuthentiCare® (PDF)
Pfizer COVID-19 Vaccine Name Change to Comirnaty (PDF)
KanCare All MCO Fall 2021 Virtual Training (PDF)
August Monthly Reference Update (PDF)
Prior Authorization Updates (PDF)
2021 Updates to Medicare Guidelines for Unacceptable Diagnosis Codes (PDF)
Mobile Crisis Intervention Services Provided by a CMHC PDF
Preferred Drug List Update (PDF)
Third Dose of Pfizer and Moderna COVID-19 Vaccine (PDF)
Performing Provider Affiliation Project (PDF)
Rate Increase for Speech Therapy Evaluation and Treatment (PDF)
Kansas Prescription Drug Monitoring Program (PDF)
NCCI-MUE Editing - October 2021 (PDF)
Breast Reduction Coverage Codes (PDF)
Rate Increase of WORK Independent Counseling (PDF)
Codes Allowed for Additional Provider Types and Specialties (PDF)
Additional COVID-19 Monoclonal Antibody Infusion Codes (PDF)
External Independent Third-Party Review (PDF)
UPDATED - July 2021 HCPCS (PDF)
340B Provider Claim Identification and Drug Rebate Invoicing Process (PDF)
Coverage of MenACW-TT (Menquadfi) Vaccine (PDF)
Coverage of Vaxelis Vaccine (PDF)
KanCare Coverage of Vitamin D Products for Infants (PDF)
External Independent Third-Party Review (PDF)
Preferred Drug List Update (PDF)
Patient Access and Interoperability (PDF)
Environmental Scan Survey (PDF)
State Fiscal Year End Notification (PDF)
UPDATED - Indian Health Services (IHS) Enrollment (PDF)
Prior Authorization Updates (PDF)
UPDATED - Autism - CCTS and IIS Clarification on Provider Enrollment Requirements (PDF)
UPDATED - 2021 Anesthesia Conversion Factor (PDF)
Preferred Drug List Update (PDF)
Pilot Program - STEPS - Supports and Training for Employing People Successfully (PDF)
KanCare All MCO HCBS 2021 Virtual Training (PDF)
Top Provider Enrollment Wizard and MCO Contracting Request Form Errors (PDF)
CLIA Monitoring for MCOs on Laboratory Claims (PDF)
OneCare Kansas and Targeted Case Management (PDF)
EUA Coverage Change for Bamlanivimab (PDF)
COVID-19 Monoclonal Antibody Infusions (PDF)
COVID-19 Vaccine Coverage During the Public Health Emergency - Pfizer BioNTech (Age 12-15) (PDF)
Multiple Therapists for One Student (PDF)
NCCI-MUE Editing - July 2021 (PDF)
COVID-19 Vaccine Resources During the Public Health Emergency (PDF)
Additional Providers Approved for COVID-19 Vaccine Coverage During Public Health Emergency (PDF)
Kansas Medicaid Promoting Interoperability Program Newsletter (PDF)
Reminder - Licensed SUD Providers (PDF)
Johnson & Johnson COVID-19 Vaccine Administration (PDF)
Maternal Depression Screening Billed with Modifier 59 (PDF)
Prior Authorization Process for Cancer Treatment - Auxiliary Agents (PDF)
Updated KMAP - KanCare CMHC Enrollment Guidance (PDF)
CMS PERM Program Review Process Reminder (PDF)
Advertencia: Potential Fraud Alert Reminder - Solicitation by Medical Equipment Suppliers (PDF)
Updated - Medication Assisted Treatment - Opioid Treatment Programs (PDF)
IG Provider Clean-Up - Merging IGs with Multiple Service Location IDs (PDF)
COVID-19 Vaccine Coverage During the Public Health Emergency (PDF)
Preferred Drug List Update (PDF)
Removal of Service Code H0007 from MAT Program (PDF)
KanCare All MCO Spring 2021 Virtual Training (PDF)
Medication Assisted Treatment - Non-Rebate Eligible NDCs (PDF)
NCCI-MUE Editing - April 2021 (PDF)
Brain Injury Rehabilitation Facility (BIRF) Eligibility Processes and Procedures (PDF)
Laboratory Billing & Verification of CLIA Status of Performing Laboratories (PDF)
COVID-19 Vaccine Coverage During the Public Health Emergency (PDF)
Coverage of Therapeutic Phlebotomy to Treat Polycythemia (PDF)
FMS Provider Required Enrollment Documentation (PDF)
OneCare Kansas Additional Diagnosis Codes (PDF)
Non-Licensed Professionals Administering Maternal Depression Screenings (PDF)
PHE COVID-19 Vaccine Administration Billing by Pharmacy DME Providers (PDF)
UPDATED - New COVID ICD-10 Diagnosis Codes and PCS Procedure Codes Effective January 1, 2021 (PDF)
Pediatric Cranial Remolding Helmets (PDF)
UPDATED - COVID-19 Vaccine Coverage During the Public Health Emergency (PDF)
New COVID ICD-10 Diagnosis Codes and PCS Procedure Codes Effective January 1, 2021 (PDF)
Update to DRG Grouper for January 2021 – Version 38.1 (PDF)
Reminder - HCBS Provider Qualifications Audit Process (PDF)
Preferred Drug List Update (PDF)
Cease Paper Provider Applications (PDF)
Dental Code Updates - HCPCS 2021 (PDF)
KanCare Coverage of Ferrous Sulfate Products (PDF)
Maternal Depression Screenings (PDF)
New DRG Grouper - January 2021 (PDF)
Retroactive Drug Code Coverage - HCPCS 2021 (PDF)
C-Code Updates - HCPCS 2021 (PDF)
MAPIR Version 6.3 Upgrade (PDF)
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2020
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COVID-19 Communications Update (PDF)
Contracting and Credentialing Process (PDF)
Aetna Secure Portal Training Webinars - Dates for 2021 (PDF)
Aetna Remittance Advice Webinars - Dates for 2021 (PDF)
Aetna New Provider Orientation Training Webinars - Dates for 2021 (PDF)
Aetna Cultural Competency Webinars - Dates for 2021 (PDF)
Aetna Executive Webinars Announcement New Dates for 2021 (PDF)
Labor Day Holiday Check Run (PDF)
UPDATE: Removal of Prior Authorization for Targeted Case Management (PDF)
Reminder of Billing POA Indicators on Inpatient Claim (PDF)
Overpayment Recovery Schedule 070620 (PDF)
Incontinence Supply Limit Changes (PDF)
ABHKS Changes in Prior Authorization/Precertification and Admissions Protocols (PDF)
ABHKS COVID-19 Update - PA and Admission Protcols (PDF)
ABHPN Check Run Schedule Memorial Day (PDF)
ABHKS COVID-19 Update - PA and Admission Protocol (PDF)
ABHKS Provider Notice - Retroactive Enrollment (PDF)
ABHKS Provider Notice - Executive Updates Webinars - New Dates for April - June 2020 (PDF)
ABHKS Provider Notice - HCBS Open Forum June 2020 (PDF)
ABHKS Provider Notice - New Provider Orientation - New Dates for April - June 2020 (PDF)
ABHKS Provider Notice - Provider Portal Webinars - New Dates for April - June 2020 (PDF)
Provider Notice - Billing Code 41899 (PDF)
ABHKS Provider Notice: Provider Townhalls March 2020 Amended (PDF)
ABHKS Provider Notice - HCBS Open Forum March 2020 (PDF)
ABHKS Provider Notice - FQHC/RHC Open Forum - March 2020 (PDF)
ABH KS Provider Notice: Provider Town Halls Announced Spring/Summer 2020 (PDF)
KMAP General Bulletin: MAPIR 6.2 Attestation Instructions (PDF)
KMAP Hospital Bulletin: DRG Reimbursement Clarification (PDF)
KMAP HCBS Bulletin: Updated - Adding Services for AuthentiCare Coverage (PDF)
KMAP General Bulletin: NPI Effective Date Update (PDF)
ABHKS Provider Notice: Sign Up for Email Alerts (PDF)
ABHKS Provider Notice: Reminder Transition of Care Period Ends 3/31/20 (PDF)
ABHKS Provider Notice: New Remittance Advice (PDF)
HCAIP Reductions Implemented (PDF)
Removal of Prior Authorization for Code 58340 (PDF)
KMAP Bulletin - Preferred Drug List Update (PDF)
HPV Vaccinations Webinar - 1/30/20 (PDF)
Provider Notice - Remittance Advice Training Webinars 2020 (PDF)
Provider Notice - Prior Authorization Tool (PDF)
Aetna Executive Webinars Announcement New Dates for 2020 (PDF)
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Preferred Drug List Update (PDF)
COVID-19 Vaccine Coverage During the Public Health Emergency (PDF)
Rate Adjustments to Support Faster High Throughput Technology COVID-19 Diagnostic Testing (PDF)
DRG Weights and Rates - January 2021 (PDF)
NCCI-MUE Editing - January 2021 (PDF)
Daily Swing Bed Rates for Calendar Year 2021 (PDF)
Provider Application Fee Change - 2021 (PDF)
Reimbursement of Inpatient Rehabilitation Distinct Part Units of a Hospital (PDF)
Counseling Codes for EPSDT (PDF)
Tribal Facilities as Federally Qualified Health Centers (TFQHCs) (PDF)
DME Providers Supplying Prefabricated Off-the-Shelf Orthotics (PDF)
NovoSeven RT - Medical Benefit Coverage (PDF)
Extension of the MCO OneCare Kansas Eligible Look Back Period (PDF)
Prior Authorization Updates (PDF)
Prothrombin Time (PT/INR) Monitoring for Home Anticoagulation Management (PDF)
Adding Services for AuthentiCare Coverage – HCBS/TA (PDF)
Two-Tier Blended Rates for ER Professional Claims (PDF)
Preferred Drug List Update (PDF)
Processing Claims for Newborn Services Using Mother's Beneficiary ID Number (PDF)
Medicare Part D Copayment Assistance Annual Update (PDF)
Tobacco (Nicotine) Cessation Medication Coverage - Age Update (PDF)
UPDATED - External Independent Third-Party Review (PDF)
Clarification on Use of Q3014 (PDF)
Preferred Drug List Update (PDF)
REMINDER - Blanket Denial Letter Attestation (PDF)
Clarification on Age Ranges and Telemedicine Coverage with H0036 and H2017 Codes (PDF)
Allowance of T2011 via Telemedicine (PDF)
Single State Audit (SSA) KMAP Provider Bulletin Notice 2020 (PDF)
Kansas Psychiatric Residential Treatment Facility (PRTF) Medical Necessity Criteria (PDF)
Enhanced Care Services May Be Agency Directed (PDF)
UPDATED - HCBS Provider Retainer Payments (PDF)
Prior Authorization Updates (PDF)
Preferred Drug List Update (PDF)
HHS Expands Relief Fund Eligibility and Updates Reporting Requirements (PDF)
CMS PERM Program Review Process (PDF)
Annual Attestation Requirement (PDF)
KMAP CRL Post Implementation (PDF)
C-Code Update - October 2020 (PDF)
KMAP Provider Revalidation Clarification (PDF)
HCPCS Changes - October 2020 (PDF)
Preferred Drug List Update (PDF)
Hospice Payment Rates for FFY 2021 (PDF)
UPDATED - Medication Assisted Treatment - Office Based Opioid Treatment (OBOT) Programs (PDF)
2020 Updates to the Medicare Guidelines for Unacceptable Principal Diagnosis Codes (PDF)
NCCI-MUE Editing - October 2020 (PDF)
KanCare All MCO Fall 2020 Training (PDF)
Chiropractic Services Coverage (PDF)
Preferred Drug List Update (PDF)
CMS Required Retrospective Drug Utilization Review (PDF)
Allow Diabetic Shoes Under the DME Specialty Code 250 (PDF)
Medicaid Promoting Interoperability Program Eligible Providers - 2020 Overview (PDF)
ICD-10 Changes - August 2020 (PDF)
Brain Injury Replacing Traumatic Brain Injury Waiver (PDF)
NEMT Coverage for OTP and OUD Assessments (PDF)
Policy Addendum for Dental Prophylaxis Codes (PDF)
UPDATED - Telemedicine Updates in Response to COVID-19 Emergency (PDF)
NEMT Services for Wheelchair Seating Assessments (PDF)
Prior Authorization Updates (PDF)
UPDATED - COVID-19 Public Health Emergency Temporary Waivers (PDF)
Preferred Drug List Update (PDF)
Home Health Regulatory Revisions (PDF)
Coverage of CPT Code 64635 (PDF)
Enteral Formula Pricing Methodology Change (PDF)
The CMS Team Provided a Medicaid & CHIP Provider Relief Fund Update (PDF)
OneCare Kansas Health Action Plan Bonus Clarification (PDF)
REMINDER - HCBS Background Check Policy (PDF)
REMINDER - HCBS Provider Qualifications Audit Process (PDF)
Expansion of Mastectomy Coverage for Males (PDF)
CARES Act Provider Relief Fund - Don't Wait - Apply Now! (PDF)
Application Fee Waived During COVID-19 Emergency (PDF)
NCCI-MUE Editing - July 2020 (PDF)
HCPCS C-Code Update - July 2020 (PDF)
HCPCS Code Update - July 2020 (PDF)
Preferred Drug List Update (PDF)
Prior Authorization Updates (PDF)
Tamsulosin® Gender Edit Update (PDF)
UPDATED - Dental Codes Allowed by Telephone During the COVID-19 Emergency (PDF)
UPDATED - Additional Telemedicine Coverage for BI Waiver Services During COVID-19 Emergency (PDF)
Updated Coverage of Wheelchair Seating Assessments for Medicaid Members (PDF)
KanCare All MCO HCBS 2020 Virtual Training (PDF)
UPDATED - COVID-19 Drug Shortage - Albuterol Inhalers (PDF)
UPDATED - Expansion of Telemedicine Services for Therapy Services During COVID-19 Emergency (PDF)
UPDATED - OneCare Kansas Guidance During COVID-19 Public Health Emergency (PDF)
UPDATED - SED Waiver Codes Allowed via Telemedicine During COVID-19 Emergency (PDF)
UPDATED - Additional E/M Codes Allowed via Telemedicine During COVID-19 Emergency (PDF)
UPDATED - Additional Codes Added to Telemedicine During COVID-19 Emergency (PDF)
UPDATED - Tobacco Cessation Counseling via Telemedicine During COVID-19 Emergency (PDF)
Medical Benefit Coverage for Thyrogen® (PDF)
Coverage for Low Dose Lung CT (PDF)
CARES Act Relief Fund for Providers (PDF)
May 2020 Post Implementation (PDF)
Coverage Guidance and Rate Updates for CPT Codes 81229 and 81243 (PDF)
Preferred Drug List Update (PDF)
Rate Adjustments for COVID-19 Testing (PDF)
UPDATED - Coronavirus (COVID-19) Coverage (PDF)
COVID-19 Testing and Treatment Services for Members with Unmet Spenddown (PDF)
Expansion with Select Telemedicine Allowed Codes/Home Setting (PDF)
Prior Authorization Updates (PDF)
Gender Restriction for ICD-10 Diagnosis Code Update (PDF)
KMAP Provider Enrollment Wizard System Upgrade Complete (PDF)
Future Drug Coverage Through Home Infusion Services (PDF)
KMAP Provider Enrollment System Upgrade (PDF)
Enrollment Types, NPI Requirements, and MCO Contracting Request Form Notifications (PDF)
Clarification of Written Consent Documentation Requirement for Telemedicine (PDF)
Update to DRG Grouper Version 37 (PDF)
Disaster Emergency Exceptions - I/DD Telemedicine Services During COVID-19 Emergency (PDF)
UPDATED - Expand Telemedicine to HCBS Services During COVID-19 Emergency (PDF)
Telemedicine Billing Guidelines During COVID-19 Emergency (PDF)
UPDATED - KMAP CMS 1500 Form Update (PDF)
Midwife Billing for Newborn Home Visits (PDF)
Preferred Drug List Update (PDF)
HCBS Disaster Emergency Exceptions - Specialized Medical Care During COVID-19 Emergency (PDF)
COVID-19 Stimulus Funds for HCBS Beneficiaries and Residents of Long-Term Care Facilities (PDF)
HCBS Background Check Exceptions During COVID-19 Emergency (PDF)
UPDATED - Smoking and Tobacco Cessation Counseling (PDF)
KDHE Promoting Interoperability Program News and Notes (PDF)
Extension of COVID-19 Emergency Policies Through June 30, 2020 (PDF)
Disaster Emergency Exceptions - Personal Care Services During COVID-19 Emergency (PDF)
KanCare All MCO HCBS 2020 Training (PDF)
Spanish Sterilization Form Available on KMAP (PDF)
Revision to April 2020 NCCI PTP and MUE Files - Telemedicine and COVID-19 Related Services (PDF)
Sequestration Reduction - RHC, FQHC and Indian Health Centers (PDF)
LEA Billing Requirements (PDF)
Hysterectomy Documentation Requirements (PDF)
COVID-19 KMAP Provider Information Page (PDF)
NCCI-MUE Editing - April 2020 Second Revision NCCI/PTP - January 2020 (PDF)
HCPCS Changes - April 2020 (PDF)
UPDATED - Coverage of COVID-19 Testing and Treatment (PDF)
HCPCS Changes - April 2020 (PDF)
KanCare Telemedicine Reimbursement Update (PDF)
MCO Meeting Cancellation (PDF)
MAPIR Application Deadline Extended (PDF)
Coronavirus (COVID-19) Coverage (PDF)
Total Parenteral Nutrition (TPN) Solution Pricing (PDF)
Environmental Scan Survey (PDF)
Prior Authorization Updates (PDF)
NCCI/MUE Editing January 2020 - Revised (PDF)
MAPIR 6.2 Attestation Instructions (PDF)
KMAP DRG Reimbursement Clarification (PDF)
UPDATE: HCBS – Adding Services for AuthentiCare Coverage (PDF)
NPI Effective Date Update (PDF)
2020 MS-DRG Weights and Rates Update (PDF)
Expansion of Brain Injury Waiver (PDF)
PD Crisis Exception Policy (PDF)
KanCare All MCO Spring 2020 Training (PDF)
UPDATED - Adult Care Home Nursing Facility Medicaid Enrollments (PDF)
HCBS Provider Qualifications Audit Process (PDF)
Preferred Drug List Update (PDF)
Reminder - Billing for Kansas Telemedicine Act (PDF)
MAPIR Version 6.2 Upgrade (PDF)
HCBS – Adding Services for AuthentiCare Coverage (PDF)
New DRG Groupers for 2020 (PDF)
KEES Transition to Oracle Cloud Infrastructure (OCI) (PDF)
Prior Authorization Updates (PDF)
Preferred Drug List Update (PDF)
Non-Covered Code for Title XXI (PDF)
HCPCS Changes - Annual 2020 (PDF)
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2019
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12.20.19 ABHPN Transition of Care Extension to 3.31.20 (PDF)
12.20.19 Aetna Cultural Competency Webinar Dates Announcement (PDF)
12.18.19 Aetna Better Health of Kansas Cultural Competency Provider Training
12.2.19 Non-Registered Provider Return Claim Notification (PDF)
12.2.19 Claims Timely Filing Exception for 2019 (PDF)
11.27.19 ABHPN Check Run Schedule Holidays 2019 (PDF)
11.27.19 Final Notice Overpayments & Recoveries (PDF)
11.26.19 ABHPN Provider Notice Overpayments (PDF)
11.25.19 ABHPN Overpayments and KanCare Log (PDF)
11.19.19 ABHPN Overpayment Error (PDF)
11.19.19 ABHPN Billing UOS (PDF)
11.15.19 Enroll in EFT and ERA Today to Get Paid Quicker (PDF)
10.29.19 Skygen Provider Notice - Covered Anesthesia Code for Dental Services (PDF)
10.29.19 Skygen Provider Notice - Remove PA for Vision Services Codes (PDF)
10.29.19 Skygen Provider Notice - Dental and Vision Claims with TPL (PDF)
10.28.19 Provider Townhalls Announced (PDF)
10.25.19 HCPCS Nusinersen Updates (PDF)
10.24.19 Executive Webinars Announced – New Dates (PDF)
10.17.19 Removal of PA for T1001 and H2016 (PDF)
10.17.19 Removal of PA for Nursing Facility/Custodial Care and Intermediate Swing Bed Services (PDF)
10.11.19 Provider Overpayments & Recoveries (PDF)
10.8.19 Aetna Transition of Care Authorizations Extended through December 31, 2019 (PDF)
10.2.19 Transition of Care Extension Update (PDF)
10.1.19 Check Run Errors 9.24.19 (PDF)
9.3.19 Enhanced Provider Search for Opioid/Specialized Expertise Providers (PDF)
8.30.19 Extending the Transition of Care Period Through 10.31.19 (PDF)
8.30.19 Removal of PA for Targeted Case Management (T1017) (PDF)
8.27.19 Check Run Schedule Labor Day Week (PDF)
8.19.19 Updated for Providers Regarding Aetna Integrated Services Plan (PDF)
8.1.19 Monthly Webinar Training (PDF)
7.16.19 Aetna Better Health of Kansas Weekly Bulletin (PDF)
7.2.19 Preferred Drug List Update (PDF)
6.27.19 Provider Corrected Claims Process (PDF)
6.24.19 Provider Meeting Invitation (PDF)
6.19.19 All MCO Spring Aetna Presentation (PDF)
5.20.19 835's on Change HealthCare's Payment Manager (PDF)
Extension of Certain Transitional Care Practices (PDF)
2-26-19 Member Portal Revision related to updates to the IVR system (PDF)
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Peer Support Rate Increase (PDF)
Cognitive Therapy Code Change (PDF)
2020 MS-DRG Weights and Rates (PDF)
NOC/NOS Drug HCPCS Code to NDC Crosswalk Website (PDF)
Provider Application Fee Update (PDF)
HCBS Provider Qualifications (PDF)
2020 Anesthesia Conversion Factor (PDF)
90-Day Supply Maintenance Drug List (PDF)
Medicare Part D Copay Assistance Update (PDF)
REMINDER - Provider Enrollment Managed Care Regulation Implementation Update (PDF)
REMINDER - NCCI PTP Modifiers (PDF)
Preferred Drug List Update (PDF)
NCCI/MUE Editing - January 2020 (PDF)
Provider Enrollment Managed Care Regulation Implementation Update (PDF)
Newborn Hearing Screening Billing (PDF)
External Independent Third-Party Review (PDF)
Prior Authorization Updates (PDF)
Aetna Better Health® of Kansas Provider Town Hall Meetings Announced (PDF)
Preferred Drug List Update (PDF)
MCO Payment of Flu Vaccines for Adults through Pharmacy Benefit (PDF)
Coverage of Diagnostic and Screening Mammography (PDF)
KMAP Provider Revalidation Reminder (PDF)
HCPCS Nusinersen Updates (PDF)
HCPCS Code Billing Updates (PDF)
Revenue Code Change for LTC Room and Board (PDF)
Home and Community Based Service Providers Individual Enrollment (PDF)
Aetna Transition of Care Authorizations Extended through December 31, 2019 (PDF)
Medicare Unacceptable Principal Diagnosis Codes (PDF)
Hospice Payment Rates FFY 2020 (PDF)
HCPCS Hydroxyprogesterone Caproate Updates (PDF)
HCPCS Updates October 2019 (PDF)
Prior Authorization Updates (PDF)
Preferred Drug List Update (PDF)
Patient Discharge Status and Occurrence Codes (PDF)
Explanation of Benefit Codes (PDF)
Enteral Formula and Parenteral Nutrition Solution Pricing Update (PDF)
Maternity Centers Billing on UB04 Form (PDF)
HCBS Background Check Policy (PDF)
Preferred Drug List Update (PDF)
Managed Care Organization Contract Request Form (PDF)
Aetna Transition of Care Authorizations Extended through October 31, 2019 (PDF)
NCCI MUEs Quarterly Updates (PDF)
Dental Procedure Codes Rate Increase (PDF)
HCBS Physical Disability Waiver Transitions (PDF)
HCBS Traumatic Brain Injury Waiver Transitions (PDF)
KanCare All MCO Fall 2019 Training (PDF)
Preferred Drug List Update (PDF)
KMAP CRL Post Implementation (PDF)
Ordering, Referring, Attending, Prescribing, and Sponsoring Provider Requirements (PDF)
Oral Sedation for Dental Procedures (PDF)
Trichloroacetic Acid Treatment in LHDs (PDF)
Rate Increase for 24-hour ventilator-dependent beneficiaries in nursing facilities (PDF)
Preferred Drug List Update (PDF)
Supportive Housing Services (PDF)
Managed Care Rule Provider Enrollment (PDF)
Fluoride Treatment in LHDs (PDF)
Utilization Review Contractor (PDF)
Important Changes for Prescribing Providers and Pharmacies (PDF)
High Frequency Chest Wall Oscillation System Pricing Update (PDF)
Vacuum Drainage Collection Unit and Tubing Kits (PDF)
G2 and PXC Qualifier Submission on Paper Claims (PDF)
NCCI MUEs Quarterly Updates (PDF)
Coverage of Codes in the ECI and LEA Setting (PDF)
Reimbursement Rates for PACE (PDF)
Coverage Expansion for Desmopressin (PDF)
Deactivation of MUEs for Contraceptive Supplies (PDF)
KanCare All MCO HCBS 2019 Training (PDF)
Coverage Limitations for Intermittent Urinary Catheters (PDF)
Preferred Drug List Update (PDF)
FQHC and RHC Physician Enrollment (PDF)
Prior Authorization Updates (PDF)
Consent for Sterilization Form (PDF)
ABHKS Provider Conference Call (PDF)
Aetna Better Health of Kansas Announces Extension of Certain Transitional Care Practices (PDF)
NCCI PRA PTP Edit File Error (PDF)
Process Improvements for the KCPC System Manual Workaround (PDF)
UPDATE: KMAP Provider Enrollment Wizard System Upgrade (PDF)
Vision Coverage for Adults (PDF)
Preferred Drug List Update (PDF)
April 2019 HCPCS Updates (PDF)
KMAP CRL Post Implementation (PDF)
Advertencia: Potential Fraud Alert Solicitation by Medical Equipment Suppliers (PDF)
KDHE Medicaid Promoting Interoperability Program Webinar (PDF)
Aetna Better Health of Kansas Announces Extension of Certain Transitional Care Practices (PDF)
Indian Health Centers and Telemedicine (PDF)
Finalized Annual Cost Reports (PDF)
Rate Increase for Autism Services (PDF)
Medically Recalled or Replaced Devices (PDF)
Preferred Drug List Update (PDF)
Actualización: Provider Enrollment Managed Care Regulation Implementation Update (PDF)
NCCI MUEs Quarterly Updates (PDF)
UPDATED Emergency Room Facility Rates (PDF)
UPDATED KBH-EPSDT Screenings (PDF)
Prior Authorization Updates (PDF)
Money Follows the Person Program End (PDF)
Medicaid Promoting Interoperability Program Webinar (PDF)
KanCare Paper Claims and MCO Checks (PDF)
REMINDER: Consent for Sterilization Form Update (PDF)
Influenza Virus Vaccines for Intranasal Use (PDF)
Rate Change for Preventative Medicine and E&M Codes (PDF)
Substance Use Disorder (SUD) Medically Unlikely Editing (MUE) (PDF)
Residential and Day Services Enrollment Requirements (PDF)
KDHE Medicaid Promoting Interoperability Program Webinar (PDF)
Preferred Drug List Update (PDF)
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