MedicaidCoverageMedium impact
KMAP BULLETIN: No Medicaid Coverage for Surgical/Pharmacologic (Hormonal) Gender Affirming Care – Adults (21 and Older)
Kansas Medicaid (KanCare)·KS · Endocrinology, Plastic Surgery, Urology +2 more·Medical Policy
Effective date
Sep 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid will no longer cover new surgical or hormonal gender affirming care for adults 21 and older starting September 1, 2025. Claims with gender dysphoria diagnosis codes will automatically suspend for manual review to check for grandfathered exceptions.
Action Required
Before September 1, 2025: Billing team must prepare for automatic claim suspensions when billing Kansas Medicaid with diagnosis codes F64.0, F64.1, F64.2, F64.8, F64.9, or Z87.890. Prepare documentation packages including medical records to demonstrate prior treatment before September 1, 2025 for grandfathered patients. Train staff to expect manual review delays for these claims.