MedicaidBilling CodesHigh impact
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
Summary
Effective June 1, 2024, Kansas Medicaid (KMAP) no longer allows pharmacy vaccine and administration services to be billed under Durable Medical Equipment (DME). All pharmacy immunizations must now be billed on professional claims using specific pharmacy provider types and NPIs.
Action Required
Immediately: Billing team must stop submitting pharmacy vaccine and administration services under DME benefit (25/255). Update billing system to use Pharmacy (32/240) provider NPI as billing provider and Pharmacist (32/276) provider NPI as rendering provider for all pharmacy immunization services. Submit these services on professional claims only. Verify KanCare MCO implementation status via KMAP Open Claims Resolution Log before reprocessing any denied claims.