MedicaidCoverageMedium impact
KMAP BULLETIN: Pharmacist as Provider – EOAs and MTM
Kansas Medicaid (KanCare)·KS · Pharmacy·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now covers Medication Therapy Management (MTM) services provided by pharmacists for Emergency Opioid Antagonist (EOA) education and dispensing, effective retroactively to January 1, 2025. Pharmacists can bill CPT codes 99605 ($40) and 99606 ($30) with specific NDC requirements, limited to 2 interventions per member per year.
Action Required
Immediately: Pharmacy billing teams must update systems to bill CPT codes 99605 ($40) and 99606 ($30) for pharmacist MTM services related to EOA education. Ensure performing provider uses pharmacist NPI (32/276) and billing provider uses pharmacy NPI (32/240). Include valid 11-digit NDC codes for EOA medications. Limit billing to 2 interventions per member per rolling year. Follow Kansas State EOA Protocol requirements.