MedicaidBilling CodesMedium impact
KMAP BULLETIN: E/M Modifier 25 Use with KBH Vision Code 99173
Kansas Medicaid (KanCare)·KS · Family Medicine, Pediatrics, Optometry·Coding
Effective date
Apr 1, 2022
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now allows modifier 25 to be billed with E/M codes when vision screening code 99173 is performed during the same KBH (Kan Be Healthy) visit. This prevents automatic denials of the vision screening code and allows both services to be reimbursed.
Action Required
Immediately for Kansas Medicaid KBH visits: Billing team must add modifier 25 to E/M codes when billing vision screening code 99173 on the same visit. Update billing system rules to automatically append modifier 25 in these scenarios. Rebill any previously denied claims for code 99173 with KBH E/M visits using modifier 25.