MedicaidReimbursementMedium impact
KMAP BULLETIN: UPDATED: Rate Changes for Physician-Administered Drugs – January 2026
Kansas Medicaid (KanCare)·KS · Oncology, Rheumatology, Neurology +3 more·Claims & Billing
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Effective January 1, 2026, Kansas Medicaid rates for physician-administered drugs (PADs) will be updated to match Medicare Part B rates. Special pricing rules apply for high-dollar rare disease drugs and LARC products, with some changes being retroactive.
Action Required
By January 1, 2026: Billing team must verify that Kansas Medicaid reimbursement rates for physician-administered drugs are updated in the billing system to reflect new CMS Medicare Part B rates. Monitor the KanCare Open Claims Resolution Log for MCO implementation dates as timing may vary by managed care organization. Review any high-dollar rare disease drug claims against General Bulletin 25274 pricing guidelines.