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MedicaidReimbursementMedium impact

KMAP BULLETIN: DRG Weights and Rates for January 2025 – Update

Kansas Medicaid (KanCare)·KS·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

The Kansas Medical Assistance Program (KMAP) has updated Medicare Severity Diagnosis-Related Groups (MS-DRG) weights and rates effective January 1, 2025. This affects hospital billing and reimbursement rates for Medicaid patients with discharge dates on or after January 1, 2025.

Action Required

Action needed
Immediately: Billing team must access the updated Hospital DRG Weights and Limits and Hospital Rates from the Interactive Tools section on the KMAP website. Review updated Hospital Fee-For-Service Provider Manual, Hospital Base Rates pages 101-105 for specific changes. Monitor the KanCare Open Claims Resolution Log for MCO implementation dates as KanCare MCOs may implement at different times than the January 1 effective date.