MedicaidCoverageMedium impact
KMAP BULLETIN: No Medicaid Coverage for Gender Affirming Care
Kansas Medicaid (KanCare)·KS · Endocrinology, Family Medicine, Internal Medicine +3 more·Medical Policy
Effective date
Feb 25, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid will deny all claims for gender affirming care treatments for members aged 20 and younger, effective retroactively to February 25, 2025. This includes pharmacy claims for certain hormones and medical claims with gender dysphoria diagnosis codes, which will be automatically rejected during claim processing.
Action Required
By October 1, 2025: Billing team must update claim submission processes to flag and avoid submitting Kansas Medicaid claims for members aged 20 and younger that include diagnosis codes F64.0, F64.1, F64.2, F64.9, or Z87.890. Update billing system to alert staff when these codes are used for young Kansas Medicaid patients. Review and reprocess any claims with these codes submitted since February 25, 2025, as they will be denied retroactively.