MedicaidAdministrativeMedium impact
KMAP BULLETIN: REMINDER HCBS Ordering Provider EVV Clarification
Kansas Medicaid (KanCare)·KS · Family Medicine, Internal Medicine, General Practice·Specialty Services
Effective date
Nov 1, 2025
We identified it
Jun 21, 2026
Summary
Starting November 1, 2025, Kansas Medicaid MCOs must include ordering provider information (name and NPI) and diagnosis codes for all Home and Community-Based Services (HCBS) authorizations subject to Electronic Visit Verification (EVV). Seven specific HCBS service codes are affected, requiring proper ordering provider documentation from CMS Form 485 or alternative sources.
Action Required
Before November 1, 2025: Billing team must ensure all HCBS EVV authorizations include ordering provider's first name, last name, and NPI from CMS Form 485. If Form 485 unavailable, use primary care provider or discharging physician temporarily. Include diagnosis code from Form 485 or use R68.89 as standard HCBS EVV diagnosis code. Update authorization submission processes for codes T1000, T1001, T1002, T1004, and T1005 with corresponding EVV codes.