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MedicaidReimbursementMedium impact

KMAP BULLETIN: Rate Changes for Physician Administered Drugs – April 2025

Kansas Medicaid (KanCare)·KS · Oncology, Rheumatology, Gastroenterology +4 more·Claims & Billing
Effective date
Apr 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Medicaid will update reimbursement rates for physician-administered drugs (PADs) to match Medicare Part B rates effective April 1, 2025. This affects all HCPCS codes for PADs except high dollar rare disease drugs and unlisted procedure codes, which maintain existing pricing structures.

Action Required

Action needed
Before April 1, 2025: Billing team must verify updated Medicaid reimbursement rates for physician-administered drugs in billing system to reflect new Medicare Part B pricing. Monitor KanCare MCO implementation dates on KMAP Bulletins page as actual implementation may vary by MCO. Update fee schedules and expected payment amounts for PAD claims.