MedicaidCoverageMedium impact
Appendix K Transition and Guidance
Kentucky Medicaid·KY · Occupational Therapy, Physical Therapy, Psychiatry·Provider Letter
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Kentucky is transitioning away from COVID-19 Appendix K flexibilities for Home and Community Based Services (HCBS) waivers, with new waiver applications taking effect between January 1, 2024 and April 1, 2024. Key changes include updated service limits for attendant care, elimination of certain service caps, and new telehealth allowances for specific therapy and case management services.
Action Required
By January 1, 2024 (Model II Waiver) and April 1, 2024 (other waivers): Billing teams must update service authorization limits for Kentucky Medicaid HCBS waiver participants. Update attendant care limits to 45 hours per week OR $200 per day for HCB waiver. Remove $40,000/$63,000 service caps for MPW waiver participants. Verify telehealth billing requirements are met for allowed services including case management, occupational therapy, speech therapy, and behavioral services. Update participant-directed service rates to reflect 21% legislative increase for non-residential services.