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Health services are purchased through either a managed care model or a fee-for-service model. The KanCare program is the State of Kansas' managed care program. KanCare is provided to all Medicaid and CHIP consumers.
5) If you do not find the specific code, you can search further in reference codes by procedure, NDC or Diagnosis. Another option is ‘Download Fee Schedules’. Select Program MediKan and Rate Type Outpatient.
KDHE-DHCF (Kansas Department of Health and Environment – Division of Health Care Finance) maintains official medical assistance eligibility policy in two manuals. The manuals are MKEESM, generally used with Elderly and Disabled medical programs, and KFMAM, with Family Medical programs.
The KanCare health plans must pay at least 100 percent of the current fee-for-service Medicaid rate (as of 11/9/12) to all contracted, in-plan providers. The rate cannot decrease for the life of the KanCare contracts. You can negotiate a different reimbursement structure if you would like to do so.
This manual and all related materials are for the traditional Medicaid fee-for-service program only. For provider resources available through the KanCare managed care organizations, reference the . KanCare website. Contact the specific health plan for managed care assistance.
Corrected fee schedules for May 2022 through November 2022 have been posted to the Kansas Medical Assistance Program (KMAP) Public Portal under Interactive Tools, KMAP Fee Schedules.
Fee-for-Service Provider Manual, Section 7020, Newborn Services, for specific billing instructions. Claim Reimbursement for Retroactive Medicaid Eligibility . In a limited number of cases, a MediKan or Medicaid beneficiary may become retroactively eligible.
Last updated July 2023. Learn more about Managed Care Organization (MCO) and Fee-For-Service (FFS) Billing Codes.
Except as otherwise noted in the plan, state developed fee schedule rates are the same for both governmental and private providers for the above services. The agency’s fee schedule rate was set as of April 1, 2021 and is effective for services provided on or after that date. The agency’s established fee
We have reviewed the proposed Kansas State Plan Amendment (SPA) to Attachment 4.19-B, KS-20-0009, which was submitted to the Centers for Medicare & Medicaid Services (CMS) on May 7, 2020. This plan amendment replaces manual pricing rules with a fee schedule of reimbursement codes for Total Parental Nutrition (TPN).