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MedicaidBilling CodesMedium impact

KMAP BULLETIN: Update to Cognitive Therapy Code Change on the BI Waiver

Kansas Medicaid (KanCare)·KS · Occupational Therapy, Physical Therapy, Speech Therapy·Coding
Effective date
Feb 1, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Brain Injury waiver program is replacing CPT codes 97129 and 97130 with new codes 97535 and 97357 for cognitive therapy services effective February 1, 2024. The new codes have different MUE (Medically Unlikely Edits) daily limits that billing teams must follow.

Action Required

Action needed
By February 1, 2024: Billing team must update system to replace CPT codes 97129 and 97130 with 97535 (8 units/2 hours daily limit) and 97357 (6 units/1.5 hours daily limit) for Kansas Brain Injury waiver cognitive therapy services. Update billing software to enforce new MUE limits. Update encounter forms and provider documentation to reflect new code descriptions.

Affected Billing Codes

97129
97130
97535
97357