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MedicaidCoverageMedium impact

KMAP BULLETIN: Adding New Provider Types and Specialties to PET Scans

Kansas Medicaid (KanCare)·KS · Cardiology, Emergency Medicine, Family Medicine +16 more·Provider Bulletin
Effective date
Jan 1, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Medicaid (KMAP) has expanded which provider types can bill for PET scans for oncology purposes, effective January 1, 2024. The policy adds 22 new provider types and specialties who can now bill PET scan codes at 85% of Medicare rates.

Action Required

Action needed
Immediately: Billing team must verify provider specialty codes in system match the approved PT/PS list for Kansas Medicaid PET scan billing. Update billing software to allow PET scan codes 78608, 78811-78816 for the 22 newly approved provider types. Verify reimbursement rate is set to 85% of Medicare rate for these codes.

Affected Billing Codes

78608
78811
78812
78813
78814
78815
78816