MedicaidBilling CodesMedium impact
KMAP BULLETIN: Children’s Integrated Community Supports – HCBS I/DD Waiver – Billing Codes and Rate Updates
Kansas Medicaid (KanCare)·KS · Pediatrics·Claims & Billing
Effective date
May 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid updated billing codes and rates for Children's Integrated Community Supports under the HCBS I/DD Waiver, establishing two service ratios (1:3 and 1:2) with specific modifiers and rates. MCOs must collaborate with families and providers to determine appropriate service ratios before authorization.
Action Required
By May 1, 2025: Billing team must update system to use HCPCS code S5125 with modifier U1 (1:3 ratio at $1.65 per 15 minutes) or U2 (1:2 ratio at $2.48 per 15 minutes) for Children's Integrated Community Supports services. Coordinate with Kansas MCOs to obtain proper service ratio authorization before billing. Ensure Electronic Visit Verification (EVV) is implemented for all CHICS services regardless of modifier used.