MedicaidAdministrativeMedium impact
KMAP BULLETIN: MS-DRG Update for January 2025
Kansas Medicaid (KanCare)·KS·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid is implementing Medicare Severity Diagnosis-Related Group (MS-DRG) Grouper version 42 effective January 1, 2025, which will affect how inpatient claims are grouped and processed. This system update changes the MS-DRG classifications used for hospital billing and reimbursement calculations.
Action Required
By January 1, 2025: Billing team must ensure hospital billing systems are updated to MS-DRG Grouper version 42 for all inpatient discharge claims. Verify with hospital billing software vendor that the update has been installed. Review the CMS summary of MS-DRG grouping changes and update any internal billing procedures accordingly. Note that KanCare MCO implementation may vary - monitor the KMAP Open Claims Resolution Log for MCO-specific implementation dates.