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MedicaidReimbursementMedium impact

KMAP BULLETIN: Rate Changes for Physician-Administered Drugs – October 2025

Kansas Medicaid (KanCare)·KS · Oncology, Rheumatology, OB-GYN +3 more·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Medicaid rates for physician-administered drugs (PADs) with HCPCS codes will be updated to match Medicare Part B rates effective October 1, 2025. High-cost rare disease drugs and LARC products follow separate pricing rules, with LARC price changes applied retroactively.

Action Required

Action needed
By October 1, 2025: Billing team must verify Kansas Medicaid reimbursement rates for all physician-administered drugs are updated in billing system to reflect new Medicare Part B rates. Check KanCare MCO implementation status on KMAP Bulletins page as MCO system updates may vary from state policy date. Monitor for reprocessing opportunities once MCOs implement the policy.