MedicaidReimbursementMedium impact
KMAP BULLETIN: Autism Codes - CCTS/IIS Coverage
Kansas Medicaid (KanCare)·KS · Psychiatry, Pediatrics·Medical Policy
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid (KMAP) expanded coverage for autism-related applied behavioral analysis codes, allowing CCTS providers to bill additional procedure codes and increasing the reimbursement rate for code 97153 to $65/hour. IIS providers can now also bill code 97154.
Action Required
By July 1, 2024: Billing team must update system to reflect new rate of $65/hour ($16.25 per 15-minute unit) for CPT 97153 applied behavioral analysis services. Enable billing of codes 97154 and 97158 for CCTS providers (PT/PS 11/403) and code 97154 for IIS providers (PT/PS 11/404). Monitor KanCare MCO implementation dates as they may vary from the effective date.