Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Kansas Medicaid (KanCare)Medicaid · Reimbursement · Claims & Billing · KSHigh impact

KMAP BULLETIN: Rate Changes for Physician-Administered Drugs – October 2026

Act
by Sep 30, 2026
Effective date
Oct 1, 2026
Identified
Sep 3, 2026

Summary

Effective October 1, 2026, KMAP will update Medicaid reimbursement rates for physician-administered drugs (PADs) by aligning pure HCPCS codes with CMS Medicare Part B rates. Unlisted procedure code drugs will continue using WAC-based rates, while High Dollar Rare Disease Drugs follow existing MCO guidelines. LARC product price changes will be retroactive to their effective dates.

Get alerts when payers change rules like this one

We check Kansas Medicaid (KanCare) and other payers every day and email you when a change matches your specialty and state.

Get Kansas Medicaid (KanCare) alertsPolicy Monitoring is free. No card required.

What to do

by Sep 30, 2026 · 5 steps
01Billing team must obtain updated KMAP fee schedules for all physician-administered drug HCPCS codes from the KMAP portal and load them into the billing system.
02Update billing software to apply the new Medicare Part B-aligned rates to all claims with dates of service on or after October 1, 2026.
03Verify that unlisted procedure codes continue to use WAC-based pricing and that HD RDD codes reference General Bulletin 25274 for MCO pricing.
04Monitor the KanCare Open Claims Resolution Log on the KMAP Bulletins page for MCO-specific implementation dates and any required reprocessing timelines.
05Communicate effective dates to all providers administering PADs.
If missed: Failure to implement updated rates may result in claim denials or overpayment recovery.

Original notice

KMAP BULLETIN: Rate Changes for Physician-Administered Drugs – October 2026
portal.kmap-state-ks.us · Always check the source before changing claims.
View original ↗

Related changes

See all Kansas Medicaid (KanCare) changes →
KMAP BULLETIN: Rate Changes for Physician Administered Drugs - January 2024MediumEffective Jan 1, 2024 · Claims & BillingKMAP BULLETIN: Rate Changes for Physician Administered Drugs – July 2024MediumEffective Jul 1, 2024 · Claims & BillingKMAP BULLETIN: Rate Changes for Physician Administered Drugs – October 2024HighEffective Oct 1, 2024 · Claims & BillingKMAP BULLETIN: Rate Changes for Physician Administered Drugs - January 2025MediumEffective Jan 1, 2025 · Claims & BillingBrowse every Kansas Medicaid (KanCare) change in the policy list

Related policy hubs

Kansas Medicaid (KanCare) policiesKS policy changes

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account