MedicaidReimbursementHigh impact
KMAP BULLETIN: Rate Changes for Physician-Administered Drugs – October 2026
Kansas Medicaid (KanCare)·KS·Claims & Billing
Effective date
Oct 1, 2026
We identified it
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.
Action Required
By September 30, 2026: Billing 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. Update billing software to apply the new Medicare Part B-aligned rates to all claims with dates of service on or after October 1, 2026. Verify that unlisted procedure codes continue to use WAC-based pricing and that HD RDD codes reference General Bulletin 25274 for MCO pricing. Monitor the KanCare Open Claims Resolution Log on the KMAP Bulletins page for MCO-specific implementation dates and any required reprocessing timelines. Communicate effective dates to all providers administering PADs. Failure to implement updated rates may result in claim denials or overpayment recovery.