MedicaidCoverageMedium impact
KMAP BULLETIN: UPDATED: New Waiver Program – Community Support
Kansas Medicaid (KanCare)·KS · Occupational Therapy, Physical Therapy, Speech Therapy +1 more·Specialty Services
Effective date
Oct 1, 2026
We identified it
Sep 18, 2026
Summary
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 waivers. The program has an annual $20,000 cost cap and covers 16+ community-based services including therapy, employment support, personal care, and transportation. Billing teams must prepare to recognize CSW as a distinct waiver category for Kansas Medicaid claims and ensure proper service coding within the cost cap constraints.
Action Required
By September 1, 2026: Billing team must prepare for CSW program implementation by: (1) Contacting KDADS and KMAP to obtain CSW-specific billing codes and claim submission guidelines for the 16 covered services (Assistive Services, Behavior Therapy, Benefits Planning, Career Exploration, Family/Caregiver Support, HEMS, Home Telehealth, IES, Life Skills, Medication Reminders, NMT, OT, Personal Care, PERS, PT, Remote Support); (2) Updating billing software to recognize CSW as a distinct waiver program with the $20,000 annual cost cap limit and implement cap monitoring to prevent over-billing; (3) Configuring system alerts to flag CSW claims and require verification of participant's approved Person-Centered Service Plan (PCSP) in documentation; (4) Training billing staff on CSW eligibility requirements (I/DD diagnosis, institutional LOC via MFEI-I/DD assessment, Kansas Medicaid financial eligibility, KDADS approval, and waiver capacity availability) to prevent submitting claims for ineligible participants; (5) Adding CSW enrollment verification step to pre-claim processing workflow. Failure to implement these changes will result in claim rejections and denied reimbursement for CSW services after October 1, 2026.