MedicaidCoverageMedium impact
KMAP BULLETIN: Penmenvy Meningococcal Vaccine Coverage
Kansas Medicaid (KanCare)·KS · Family Medicine, General Practice, Pediatrics +1 more·Medical Policy
Effective date
Jun 25, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now covers Penmenvy vaccine (CPT 90624) as an additional option for meningococcal disease prevention in ages 10+ with specific risk factors or healthy people ages 16-23. New reimbursement rates established: $250.75 for vaccine (19+) and varying administration fees based on age and VFC status.
Action Required
By June 25, 2025: Billing team must add CPT 90624 (Penmenvy vaccine) to Kansas Medicaid billing system with reimbursement rate of $250.75 for ages 19+. Update system to use correct administration codes: 90460 for ages 18 and under, 90471/90472 for ages 19+. Configure administration fees: $20.26 for VFC patients ages 10-18, $14.57 for non-VFC patients 19+. Update encounter forms to reflect new vaccine option for eligible populations.