MedicaidCoverageMedium impact
KMAP BULLETIN: Update to Cognitive Therapy Code Change on the BI Waiver
Kansas Medicaid (KanCare)·KS · Occupational Therapy, Physical Therapy·Coding
Effective date
Feb 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now allows cognitive therapy codes 97537 and 97535 to be provided virtually using telehealth place of service codes 02 and 10 for the HCBS-BI waiver program. Claims impacted by this change will be automatically reprocessed by the state.
Action Required
Immediately: Billing team should update system to allow telehealth place of service codes 02 (Telehealth Provided Other than in Patients Home) and 10 (Telehealth Provided in Patients Home) for CPT codes 97537 and 97535 when billing Kansas Medicaid HCBS-BI waiver patients. Ensure services follow the approved Person-Centered Service Plan with appropriate mix of in-person and virtual services. Monitor for automatic reprocessing of previously denied claims.