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KMAP BULLETIN: Pharmacist as Provider – Billable Services – Medication Administration

Kansas Medicaid (KanCare)·KS · Pharmacy, Psychiatry·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Days to comply

Summary

Starting January 1, 2026, enrolled pharmacists in Kansas Medicaid (KMAP) can administer select injectable medications including long-acting antipsychotics and contraceptives. The administration fee must be billed using CPT 96372 on the medical benefit with specific NDC requirements, while the drug itself is billed through pharmacy POS within 7 days.

Action Required

Action needed
Before January 1, 2026: Billing team must update system to accommodate pharmacist-administered injectable medications using CPT 96372 with mandatory NDC loop population (qualifier 2410 LIN02 value N4). Configure split billing workflow where administration is billed to medical benefit and drug to pharmacy POS within 7 days. Ensure rendering provider NPI is pharmacist (32/276) and billing provider NPI is pharmacy (32/240). Update encounter forms for covered medications including Abilify Maintena, Aristada, Invega Sustenna, Depo-Provera and others listed.

Affected Billing Codes

96372