MedicaidCoverageMedium impact
KMAP BULLETIN: Influenza Vaccine Coverage 2025-2026 Season Updates
Kansas Medicaid (KanCare)·KS · Family Medicine, General Practice, Pediatrics +2 more·Medical Policy
Effective date
Sep 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid updated influenza vaccine coverage for the 2025-2026 season, effective retroactively to September 1, 2024. The policy establishes specific reimbursement rates for three vaccine codes based on patient age, with VFC coverage for patients 18 and younger (administration only) and full reimbursement for patients 19 and older.
Action Required
Immediately: Billing team must update Kansas Medicaid influenza vaccine billing to use correct codes and rates for 2025-2026 season. Use CPT 90656 ($22.35 for 19+), 90660 ($29.71 for 19+), or 90673 ($98.16 for 19+) based on patient age. For patients 18 and younger, bill VFC for administration only using codes 90460, 90471, 90472, 90473, or 90474. Update billing system rules to differentiate between VFC and non-VFC reimbursement based on patient age.