Important Updates:

Beginning July 1 2025, late eligibility reviews will be treated as a new application. To be considered for backdated coverage, the member must answer “yes” to the question about prior medical expenses in the review. Click the link for more information: KanCare.ks.gov/ReconsiderationPolicy.

Effective October 14, 2025, Provider Electronic Solutions (PES) will no longer be supported by the Kansas Medical Assistance Program (KMAP). Users will submit EDI transactions through KMMS. There will be two town halls available to PES users to learn more about the changes. Click the link to learn more and register: Attend a Town Hall.

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Kansas Medicaid Rate Study

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Kansas Medicaid has conducted a study of reimbursement rates in comparison to Medicare and four peer states: Colorado, Iowa, Missouri and Nebraska. Results of the study are being posted to the KanCare website in batches, beginning with dental codes.

Dental Rate Study

The study reviewed the most complete data. Recent increases in adult dental rates and coverage will not be reflected in the paid amount yet. Fees in the report reflect the most fees as of the date of the report (Sept. 1, 2024).

Kansas Medicaid Rate Study Dental Codes

Evaluation and Management Rate Study

The study reviewed the most complete data. Fees in the report reflect the most fees as of the date of the report (Sept. 1, 2024).

Kansas Medicaid Rate Study Evaluation and Management Codes

Radiology Rate Study

The study reviewed the most complete data from calendar year 2022 encounter data for codes within the CPT code range 70020-79999. Radiology services include diagnostic imaging, diagnostic ultrasound, radiation oncology, mammography, nuclear medicine, radiologic guidance and bone/joint studies. Fees in the report reflect the most fees as of the date of the report (Sept. 1, 2024).

Kansas Medicaid has leveled radiology rates to align with Medicare while some state Medicaid programs have not, which impacts rate-to-rate comparisons. Because of rate-leveling, some radiology codes appear low in comparison to other states thought they are aligned with Medicare.

Kansas Medicaid Rate Study Radiology Codes

Medicine Rate Study

The study reviewed the most complete data. Fees in the report reflect the most fees as of the date of the report (Sept. 1, 2024).

Kansas Medicaid Rate Study Medicine

Pathology and Laboratory Rate Study

The study reviewed the most complete data. Fees in the report reflect the most fees as of the date of the report (Sept. 1, 2024).

Kansas Medicaid Rate Study Pathology and Laboratory Codes

Pharmacy Cost of Dispensing Survey

Under contract to the Kansas Department of Health and Environment (KDHE), Myers and Stauffer LC performed a study of pharmacy dispensing cost. The methodology was consistent with guidelines from the Centers for Medicare and Medicaid Services (CMS) in its rule for Medicaid pharmacy reimbursement regarding the components of pharmacy cost that are appropriately reimbursed by the pharmacy dispensing fee of a state Medicaid program.

Kansas Cost of Dispensing Survey Report