MedicaidBilling CodesMedium impact
KMAP BULLETIN: HCBS Brain Injury Waiver – Cognitive Therapy Billing Changes
Kansas Medicaid (KanCare)·KS · Neurology, PM&R (Physical Medicine & Rehab), Physical Therapy +1 more·Claims & Billing
Effective date
May 1, 2026
We identified it
Jun 21, 2026
Summary
Kansas HCBS Brain Injury Waiver cognitive therapy services must now be billed exclusively using CPT code 97129 instead of previously used codes 97535 and 97537. The new code has a rate of $25.00 per 15-minute unit and special billing rules for BI Waiver members.
Action Required
Before May 1, 2026: Billing team must update system to use CPT code 97129 exclusively for HCBS Brain Injury Waiver cognitive therapy services. Stop using CPT codes 97535 and 97537 for BI Waiver claims. Configure system to set rate at $25.00 per 15-minute unit and ensure EVV requirements are met. Update approved place of service codes (02, 03, 04, 10, 11, 12, 13, 16, 18, 53, 99) in billing software.