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KMAP BULLETIN: UPDATED: HCBS Rate Changes for Fiscal Year 2027

Kansas Medicaid (KanCare)·KS · Geriatrics, Occupational Therapy, Physical Therapy +2 more·Claims & Billing
Effective date
Jul 1, 2026
We identified it
Sep 10, 2026
Days to comply

Summary

KMAP has updated Home and Community Based Services (HCBS) reimbursement rates effective July 1, 2026, for Kansas state fiscal year 2027. Rates have been adjusted across multiple HCPCS codes serving Frail Elderly, Physical Disability, and Intellectual/Developmental Disability populations. Billing teams must update all rate tables in their billing system to ensure accurate claim submission and avoid underbilling or claim denials.

Action Required

Action needed
By June 30, 2026: Billing team must update all rate tables in the billing system for the 12 affected HCPCS codes across Frail Elderly (S5130, S5125), Physical Disability (S5125 variants), and Intellectual/Developmental Disability (H0045, T1019, T2025, T1000, H2023, S5161, T2040, S5190, T2016, T2021) categories. Verify rates match the FY 2027 fee schedule provided in KMAP Bulletin 26092, including all tiered rates for T2016 Residential (Tiers 1-5, Super Tiers 1-5, and UB variant) and T2021 Day Services (Tiers 1-5 and Super Tiers 1-3). Conduct system testing to confirm correct rate selection by service category and unit definition before the July 1 effective date. Failure to update rates will result in underpayment or claim denials for all HCBS services delivered on or after July 1, 2026.

Affected Billing Codes

S5130
S5125
H0045
T1019
T2025
T1000
H2023
S5161
T2040
S5190
T2016
T2021