Back to dashboard
MedicaidReimbursementMedium impact

KMAP BULLETIN: Updated - HCBS Rate Increase for Fiscal Year 2026

Kansas Medicaid (KanCare)·KS · Occupational Therapy, Physical Therapy, PM&R (Physical Medicine & Rehab)·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Medicaid (KMAP) is increasing reimbursement rates for Home and Community Based Services (HCBS) effective July 1, 2025, for fiscal year 2026. The policy includes updated rates for Brain Injury services, Technology Assisted services, and Intellectual/Development Disabilities services with specific dollar amounts per procedure code.

Action Required

Action needed
By July 1, 2025: Billing team must update fee schedules in billing system with new Kansas Medicaid HCBS rates for all affected procedure codes. Update Brain Injury services (97535, 97537, G0151, G0152, G0153, H0004) to $25.00 per 15 minutes, Technology Assisted services (T1000) to $13.75 per 15 minutes, and all I/DD service rates as specified in the bulletin. Verify system applies correct rates for Kansas Medicaid claims with dates of service on or after July 1, 2025.

Affected Billing Codes

97535
97537
G0151
G0152
G0153
H0004
T1000
H0045
H2023
S5125
S5161
S5190
T1019
T2016
T2021
T2025
T2040