MedicaidCoverageMedium impact
KMAP BULLETIN: No Medicaid Coverage for Gender Transition Surgical Care – 0-20 Years
Kansas Medicaid (KanCare)·KS · Plastic Surgery, Urology, OB-GYN +2 more·Medical Policy
Effective date
Feb 25, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid will no longer cover gender-affirming surgical care for individuals under 21, with restrictions starting February 25, 2025 for those under 18 and June 1, 2025 for ages 18-20. Claims with specific gender dysphoria diagnosis codes will be suspended for manual review and require medical records submission.
Action Required
Before February 25, 2025: Billing team must update system to flag claims with diagnosis codes F64.0, F64.1, F64.2, F64.8, F64.9, and Z87.890 for Kansas Medicaid patients under 21. Prepare medical records and clinical documentation for manual review process. Before June 1, 2025: Extend restrictions to cover surgical treatments for ages 18-20. Claims with these diagnosis codes will be suspended and require documentation submission.