MedicaidCoverageMedium impact
KMAP BULLETIN: New Waiver Program – Community Support
Kansas Medicaid (KanCare)·KS · Occupational Therapy, Physical Therapy, Speech Therapy +2 more·Specialty Services
Effective date
Oct 1, 2026
We identified it
Sep 4, 2026
Summary
Kansas Medicaid (KMAP) is launching a new Community Support Waiver (CSW) program effective October 1, 2026, for individuals with intellectual/developmental disabilities who meet institutional level of care criteria but need fewer supports than comprehensive waiver programs. The CSW has an annual cost cap of $20,000 and covers 17+ service categories including therapy, employment support, respite care, and personal care services. Billing teams must prepare to recognize CSW-eligible claims and ensure proper service coding and documentation.
Action Required
By September 1, 2026: Billing team must review and document all CSW-covered services listed in the policy (Assistive Services, Behavior Therapy, Benefits Planning, Career Exploration, Family/Caregiver Support, HEMS, Home Telehealth, IES, Life Skills, Medication Reminder Services, NMT, Occupational Therapy, Personal Care, Personal Emergency Response, Physical Therapy, Remote Support, Respite Care, and Speech-Language Pathology). Work with providers and clinical staff to: (1) Identify patients who may qualify for CSW based on I/DD program eligibility and institutional level of care criteria, (2) Ensure encounter forms and billing system templates capture CSW waiver status and service type, (3) Verify that prior authorization processes account for KDADS waiver capacity limitations and cost cap ($20,000 annually), (4) Train billing staff on Person-Centered Service Plan (PCSP) documentation requirements and how to validate CSW enrollment before processing claims. By October 1, 2026: Activate billing system rules to route CSW claims correctly and flag any claims exceeding the annual $20,000 cost cap for review. Failure to identify CSW-eligible beneficiaries may result in incorrect claim coding and potential denials if services are billed under the wrong waiver category.