MedicaidBilling CodesMedium impact
KMAP BULLETIN: UPDATED NCCI/MUE Editing – April 2025
Kansas Medicaid (KanCare)·KS·Provider Bulletin
Effective date
Apr 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid has updated NCCI/MUE editing rules for Q2 2025, including a specific change to HCPCS code J1628 where the Medically Unlikely Edit (MUE) value increased from 100 to 200 units per day. These changes affect claim processing and edit validation for Medicaid services.
Action Required
Immediately: Billing team must review current claims for HCPCS J1628 and update billing software to reflect the new MUE limit of 200 units per day (increased from 100). Monitor the KanCare Open Claims Resolution Log for MCO implementation dates and potential reprocessing opportunities for previously denied claims that exceed the old limit but fall within the new limit.