MedicaidBilling CodesMedium impact
KMAP BULLETIN: State Institutional Alternative and Psychiatric Observation
Kansas Medicaid (KanCare)·KS · Psychiatry, Pediatrics·Provider Bulletin
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid introduces new procedure code S9485 for psychiatric observation services for patients under 18 at State Institutional Alternative facilities, with reimbursement rates of $780 (July 2024) and $858 (August 2024 and after). Payment is only available if the patient is subsequently admitted to the SIA program after the observation period.
Action Required
Immediately: Billing teams at facilities providing psychiatric observation services for minors awaiting SIA admission must add procedure code S9485 to billing systems with rates of $780 for July 2024 dates and $858 for August 2024 and later. Update claim submission workflows to bill observation days on outpatient claims using SIA facility NPI, ensure psychiatric diagnosis is documented as primary or secondary, and complete Mental Health Screening Forms. Claims will be denied if patient is not subsequently admitted to SIA program.