MedicaidBilling CodesMedium impact
KMAP BULLETIN: HCBS Brain Injury Waiver – Cognitive Therapy Code Update
Kansas Medicaid (KanCare)·KS · Occupational Therapy, Physical Therapy, Speech Therapy·Coding
Effective date
Feb 1, 2026
We identified it
Jun 21, 2026
Summary
Kansas HCBS Brain Injury Waiver will revert from using CPT codes 97535/97537 to 97129/97130 for Cognitive Therapy services effective February 1, 2026. Providers can retroactively resubmit denied claims from February 2024-2026 using modifier 59 for same-day cognitive and other therapy services.
Action Required
By February 1, 2026: Billing team must update system to use CPT 97129 (initial 15 minutes) and 97130 (additional 15 minutes) instead of 97535/97537 for HCBS Brain Injury Waiver Cognitive Therapy services. Immediately: Review and resubmit denied claims from February 2024-2026 to MCO with modifier 59 on 97535/97537 when same-day cognitive therapy was provided with PT/OT/Speech services by different therapists.