MedicaidPrior AuthMedium impact
KMAP BULLETIN: Code B9998 to be Manually Priced
Kansas Medicaid (KanCare)·KS · Gastroenterology, General Practice, Family Medicine +1 more·Coding
Effective date
May 1, 2024
We identified it
Jun 21, 2026
Summary
Effective May 1, 2024, enteral supplies without assigned codes must use HCPCS code B9998 which requires prior authorization for all ages and will be manually priced at provider cost plus 35%. Enteral supplies with existing HCPCS codes must continue using their appropriate assigned codes.
Action Required
Immediately: Billing team must update system to require prior authorization for HCPCS code B9998 for all enteral supplies without assigned codes. Verify all enteral supply claims use appropriate HCPCS codes when available, only using B9998 for supplies lacking specific codes. Update billing software to flag B9998 claims for manual pricing at cost plus 35%. Train staff on new prior auth requirements to avoid claim denials.