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KMAP BULLETIN: Immunization Administration by Pharmacy Providers

Kansas Medicaid (KanCare)·KS · Pharmacy, Family Medicine, Pediatrics +1 more·Pharmacy
Effective date
Jun 1, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Effective June 1, 2024, Kansas Medicaid (KMAP) requires pharmacy vaccine administration services to be billed on professional claims using specific pharmacy and pharmacist NPIs with designated taxonomy codes. Pharmacy providers can no longer bill vaccines under the DME benefit and must enroll as specific provider types to receive reimbursement.

Action Required

Action needed
Immediately (effective June 1, 2024): Billing team must update system to require pharmacy vaccine services be billed on professional claims using Type-2 NPI for pharmacy (taxonomy 333600000X) and Type-1 NPI for pharmacist (taxonomy 1835P0018X). Ensure pharmacy providers are enrolled as PT/PS 32/240 and pharmacists as PT/PS 32/276. Stop billing pharmacy vaccines under DME benefit (PT/PS 25/255). Claims will be denied if NPI or taxonomy information is missing.