Kansas Medicaid Fee Schedule

Kansas Medicaid Fee Schedule: A Comprehensive Guide for Providers

Navigating the complexities of the Kansas Medicaid system can be daunting, especially for healthcare providers. Understanding the Kansas Medicaid fee schedule is crucial for accurate billing and timely reimbursement. This comprehensive guide provides a clear overview of the fee schedule, its intricacies, and resources to help you successfully manage your Medicaid claims. We'll demystify the process, addressing common questions and providing actionable insights to streamline your billing practices.

Understanding the Kansas Medicaid Fee Schedule

The Kansas Medicaid fee schedule is a comprehensive list that details the reimbursement rates for various medical services provided to Medicaid beneficiaries within the state. These rates are established by the Kansas Department of Health and Environment (KDHE) and are regularly updated to reflect changes in healthcare costs and market trends. It's essential to understand that this schedule isn't a static document; rates are subject to revision, and staying informed about these changes is paramount for accurate billing.

Key Components of the Fee Schedule

The fee schedule encompasses a wide range of services, including:

Physician Services: Reimbursement rates for doctor visits, consultations, and procedures.
Hospital Services: Rates for inpatient and outpatient care, including surgeries and diagnostic testing.
Durable Medical Equipment (DME): Reimbursement for items like wheelchairs, oxygen tanks, and walkers.
Pharmacy Services: Reimbursement rates for prescription drugs dispensed to Medicaid recipients.
Other Healthcare Services: This broad category includes services from various healthcare professionals, such as therapists, dentists, and podiatrists.

The specific reimbursement rate for each service is determined by several factors, including the complexity of the procedure, the provider's location (rural vs. urban), and the beneficiary's specific needs.

Accessing the Kansas Medicaid Fee Schedule

Finding the most up-to-date Kansas Medicaid fee schedule can be challenging. Unlike some states with readily accessible online databases, Kansas's information is often spread across various platforms.

Official Sources for the Fee Schedule

The primary source of information is the KDHE website. While a single, consolidated, easily downloadable fee schedule might not exist, the KDHE website frequently contains announcements of fee updates and relevant provider bulletins. It's crucial to regularly check their site for the latest information. You may also need to contact the KDHE directly through their provider relations department for specific clarifications or to request updated rate information.

Third-Party Resources

Several third-party billing software companies and medical billing consultants offer access to compiled fee schedules and assist with Medicaid billing. While using these resources can be beneficial, always verify the information against official KDHE sources to ensure accuracy.

Navigating the Reimbursement Process

Successfully navigating the Kansas Medicaid reimbursement process requires careful attention to detail and compliance with all applicable regulations.

Proper Coding and Documentation

Accurate coding is crucial for timely and accurate reimbursements. Using the correct Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes ensures that your claims align with the services rendered. Similarly, thorough and detailed medical documentation is essential to support your claims and justify the reimbursement requested.

Timely Submission of Claims

Meeting the deadlines for submitting claims is crucial. Delays can lead to payment delays or even claim denials. Familiarize yourself with the specific deadlines and submission requirements outlined by the KDHE.

Understanding Claim Denials

Even with proper coding and timely submissions, claim denials can occur. Understanding the reasons for denial and taking corrective action promptly is essential. The KDHE's website often provides information on common denial reasons, which can help you address issues proactively.

Staying Updated on Changes to the Kansas Medicaid Fee Schedule

The Kansas Medicaid fee schedule is not static. Regularly scheduled updates, often driven by legislative changes or budget adjustments, necessitate continuous monitoring of the schedule.

Subscribe to Provider Bulletins

The KDHE frequently releases provider bulletins announcing updates to the fee schedule, changes to billing procedures, and other important information. Subscribing to these bulletins is a proactive way to stay informed about critical changes.

Network with Other Providers

Networking with other healthcare providers who bill to Kansas Medicaid can be invaluable. Sharing information and experiences can help you navigate challenges and stay abreast of current trends and updates.

Conclusion

Understanding and effectively utilizing the Kansas Medicaid fee schedule is vital for healthcare providers who serve Medicaid beneficiaries. By proactively accessing and interpreting the fee schedule, implementing accurate coding practices, and staying updated on changes, providers can streamline their billing processes and ensure timely reimbursement. Remember to always utilize official sources and consider seeking assistance from experienced billing professionals when needed.

FAQs

1. Where can I find the most up-to-date Kansas Medicaid fee schedule online? While there isn't a single, easily downloadable file, the KDHE website is the official source. Regularly check their provider resources and announcements.

2. What happens if my claim is denied? Review the denial reason carefully. Common reasons include incorrect coding or missing documentation. Correct the errors and resubmit the claim within the designated timeframe. Contact the KDHE if needed for clarification.

3. Are there any resources available to help me understand the coding requirements for Kansas Medicaid? The KDHE website should offer guidance on appropriate coding, and consider professional medical billing resources for additional support.

4. How often does the Kansas Medicaid fee schedule change? The frequency of updates varies, so regular monitoring of the KDHE website and provider bulletins is crucial.

5. Can I appeal a denied claim? Yes, Kansas Medicaid has an appeals process. The KDHE website will outline the procedures for appealing a claim denial. It's important to follow these procedures carefully and document all communication.


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  kansas medicaid fee schedule: Hearings, Reports and Prints of the House Select Committee on Small Business United States. Congress. House. Select Committee on Small Business, 1972
  kansas medicaid fee schedule: New Ways of Doing Business Mark A. Abramson, Ann M. Kieffaber, 2003 In their introduction, the editors of New Ways of Doing Business assert that in retrospect, it will be apparent that today's government, that of the early years of the 21st century, 'was undergoing its most significant transformation since the decade of the 1930's when direct government-delivered services grew significantly as part of the New Deal.' This newest volume in the IBM Endowment for the Business of Government series is an invaluable guide to navigating the sometimes controversial changes taking place in the internal operations of government, the delivery of services to citizens, and the delivery of environmental programs. Possibly the most monumental change taking place in our modern government is the lessening allegiance to the old model of in-house, in-departmental performance of tasks. The new model asks 'how and by whom can the tasks of government best be performed?' The answer sometimes lies with another inter-governmental department, leading to an in-house atmosphere of healthy competition and entrepreneurship, and sometimes with outside contractors. New Ways of Doing Business provides descriptions and guidelines for successfully navigating management under the new model. There are also dramatic new ways in which services to the public can now be delivered: via the Internet, via contracts with private organizations, and via faith-based initiatives and business improvement districts. Experts provide valuable checklists and guidelines and case studies exploring the merits and disadvantages of these new service delivery routes. Finally, New Ways of Doing Business explores what the editors call one of the most highly experimental policy arenas in government, that of the delivery of environmental programs. The authors of these articles explain via case study analysis many of the innovative programs currently in existence, and postulate that the traditional 'command-and-control' stance of government to businesses will be superceded by a flexibility that will allow for increased 'eco-efficiency' and attention to market-based regulatory tools.
  kansas medicaid fee schedule: Medicaid and SCHIP states' enrollment and payment policies can affect children's access to care : report to the Ranking Minority Member, Committee on Energy and Commerce, House of Representatives ,
  kansas medicaid fee schedule: Problems in Auditing Medicaid Nursing Home Chains United States. General Accounting Office, 1979
  kansas medicaid fee schedule: Casebook of Exemplary Evidence-Informed Programs that Foster Community Participation After Acquired Brain Injury Richard Volpe, 2013-06-01 Acquired brain injury (ABI) describes damage to the brain that occurs after birth, caused by traumatic injury such as an accident or fall, or by non-traumatic cause such as substance abuse, stroke, or disease. Today’s medical techniques are improving the survival rate for people of all ages diagnosed with ABI, and current trends in rehabilitation are supporting these individuals returning to live, attend school, and work in their communities. Yet strategies on the best way of providing community participation vary among rehabilitation experts. Because many of survivors of ABI do not and will not return to the status quo of their former lives it is important to examine what constitutes best and promisingpractices in this area. This casebook is the world’s first compilation of evidence-informed programs that foster community participation for people of all ages with brain injury. With thisreview, we elicited and carefully examined existing programmatic efforts that combine emphasis on the individual, the social, and the service systems in a way that captures community participation as a complex process of interactive change in the person-environment relationship – programs that do not divorce ABI survivors from their contexts, and where participation efforts facilitate positive change in the social and political context. We considered community-based programs to be programs where individuals and families actively participate in their own therapy (rehabilitation) and take responsibility for their own health or that of a family/community member. Each case study chapter depicts a program chosen on its extraordinary merits to provide community participation to its clients. The chapters are cowritten by the stakeholder and a researcher, giving a complete perspective of how the program was established and continues to operate, and provides evidence of excellence.
  kansas medicaid fee schedule: Medicaid SpDATA System: National comparisons , 1992
  kansas medicaid fee schedule: Proposed Medicare Physician Fee Schedule United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the Environment, 1991
  kansas medicaid fee schedule: The Complete Idiot's Guide to Medical Care for the Uninsured Mark L. Friedman, Donna Raskin, 2008 At a time when healthcare costs are skyrocketing, approximately 47 million Americans are without medical insurance. Setting aside the debate over healthcare in the U.S., this guide explores the best options for those without insurance. Readers will find information on state and federal resources for the uninsured, choosing a hospital, saving on prescription medications, and when to use the emergency room and when to use a clinic. *?According to The New York Times, amore than 1?3 of the uninsureda17 million of the nearly 47 millionahave family incomes of $40,000 or morea ?According to the Kaiser Commission on Medicaid and the uninsured, there were 6.6 million uninsured people in high-income homes in 2001, and that number has now increased
  kansas medicaid fee schedule: Health Care Financing Review , 2006
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  kansas medicaid fee schedule: Trends in State Administration of Medicaid Programs David F. Chavkin, 1979
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  kansas medicaid fee schedule: 2006 Public Human Services Directory Amy J. Plotnick, 2005-12
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  kansas medicaid fee schedule: Nursing Homes in Kentucky Kentucky. General Assembly. Subcommittee on Long Term Care, Kentucky. General Assembly. Legislative Research Commission, 1977
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  kansas medicaid fee schedule: Cost Accounting for Pharmaceutical Services Jean Paul Gagnon, 1980
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  kansas medicaid fee schedule: School Finance and Education Equity Bruce D. Baker, 2022-10-18 This inspiring account of bipartisan political success delivers an expert breakdown of how and why Kansas—a politically conservative state—was able to craft a stable, balanced, and equitable system of funding for its public schools. Beyond a chronicle of one state’s achievements, School Finance and Education Equity provides invaluable policy guidance and lays out a blueprint that other states can use to strengthen their own public education systems. Readers are given an insider’s tour of the Kansas story by Bruce D. Baker, an academic researcher and expert witness in school finance litigation. With more than two decades of involvement with the state, Baker combines historical background, legal analysis, and political and economic contextual data—along with a gleaming wit—to present a thorough, enlightening narrative of Kansas’s K–12 funding journey. As Baker points out, other states can find much to learn here. He shows that, when it comes to school finance, Kansas serves as an exemplar in aligning resources to meet the promises of its constitution. State leaders rejected the pervasive notion that money doesn’t matter in education, and they gathered the data to prove that it does. Baker emphasizes that this kind of slow and steady success hinges on the ability of stakeholders to remain involved over time. Continuity is vitally important. Baker’s account highlights how persistence can overcome opposition, continuity can aid reform, and incremental gains can lead to big change. In an era of national ideological polarization and political and economic volatility, the lessons from Kansas are especially illuminating.
  kansas medicaid fee schedule: Handbook of Families and Poverty D. Russell Crane, Tim B. Heaton, 2007-10-19 Edited by two well-known family researchers at Brigham Young University, this meticulously researched compendium is a trove of useful information on areas where poverty and family issues intersect. This volume should be the first stop for anyone beginning research on poverty and families. —CHOICE The Handbook of Families and Poverty covers hotly debated issues associated with public policy and funded research as they relate to families and poverty. Contributors, bringing multiple perspectives to bear, aim to show alternatives to welfare in subgroups facing specific challenges that are currently not adequately addressed by the welfare system. Readers will appreciate the insightful summaries of research involving poverty and its relationship to couple, marital, and family dynamics. Key Features: Provides a comprehensive view of the issues surrounding families and poverty so that readers may benefit from the findings and insights of their peers in other relevant fields, with the hope that better understanding will bring better solutions. Includes several chapters on application/intervention and theoretical issues Contains writings by contributing authors who are respected experts from a broad range of disciplines and perspectives, including business; child development; family studies; psychology; public policy; social work; and sociology.
  kansas medicaid fee schedule: Kansas Administrative Regulations , 2000
Table of Contents State/Territory Name: KANSA…
The next page that appears is titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from …

Table of Contents State/Territory Name: Kansa…
Jul 3, 2023 · Reimbursement for services are based upon a Medicaid fee schedule established by the State of Kansas. …

Microsoft Word - How to locate the Medicaid Fee Schedules
You are able to click on Fee Schedule for Outpatient Hospitals. Click. 5) If you do not find the specific code, you can …

Kansas Medicaid Fee Schedule - wclc2018.iaslc.org
KMAP BULLETIN: Corrected Fee Schedules Available WEBNov 21, 2022 · Corrected fee schedules for May 2022 through …

KANSAS MEDICAID STATE PLAN - govecountyks.gov
page that appears is titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from the drop …

23169%20-%20General%20- %20Rate Increase for Physici…
The Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF) is amending the …

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Medical providers who provide services to Medicaid beneficiaries are reimbursed directly by the MCOs with whom they …

Table of Contents State/Territory Name: Kansa…
The next page that appears is titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from …

Table of Contents State/Territory Name: KANSAS
The next page that appears is titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from the drop-down list – TXIX; b. Choose the type of rates – Medicaid; c. After …

Table of Contents State/Territory Name: Kansas State Plan …
Jul 3, 2023 · Reimbursement for services are based upon a Medicaid fee schedule established by the State of Kansas. Effective January 1, 2022, additional varicose vein treatment modalities …

Microsoft Word - How to locate the Medicaid Fee Schedules
You are able to click on Fee Schedule for Outpatient Hospitals. Click. 5) If you do not find the specific code, you can search further in reference codes by procedure, NDC or Diagnosis. …

Kansas Medicaid Fee Schedule - wclc2018.iaslc.org
KMAP BULLETIN: Corrected Fee Schedules Available WEBNov 21, 2022 · Corrected fee schedules for May 2022 through November 2022 have been posted to the Kansas Medical …

KANSAS MEDICAID STATE PLAN - govecountyks.gov
page that appears is titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from the drop-down list -TXIX; b. Choose the type of rates – Medicaid; c. After …

23169%20-%20General%20- %20Rate Increase for Physician …
The Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF) is amending the Kansas Medicaid State Plan. Per Legislative allocation, select …

KanCare Provider Reimbursement - kslegresearch.org
Medical providers who provide services to Medicaid beneficiaries are reimbursed directly by the MCOs with whom they contract. MCOs are contractually obligated to reimburse providers at or …

Table of Contents State/Territory Name: Kansas
The next page that appears is titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from the drop-down list -TXIX; b. Choose the type of rates – Medicaid; c. After …

Table of Contents State/Territory Name: Kansas State Plan …
The Medicaid fee schedule will be equal to or less than the maximum allowable under the same Medicare rate, if applicable. If a service has no Kansas specific Medicare rate, Kansas will …

Kansas Medicaid Fee Schedule (Download Only)
The Kansas Medicaid fee schedule is a comprehensive list that details the reimbursement rates for various medical services provided to Medicaid beneficiaries within the state. These rates …

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KHI and KLRD are pleased to provide basic facts and information about Medicaid and CHIP in Kansas. This report, Kansas Medicaid: A Primer 2024, includes an overview of Medicaid and …

Kansas Medicaid Adult Dental coverage implemented July 1, …
Code Description Fee D1354 $15.00 D2140 Amalgam - one surface $53.50 D2150 Amalgam - two surfaces $64.00 D2160 Amalgam - three surfaces $76.00 D2161 Amalgam- four or more …

Chapter 7: Acute Care Inpatient/ Outpatient Hospital …
The Kansas Medicaid fee-for-service program reimburses for health care services in a number of different types of hospitals including: acute care, psychiatric, rehabilitative, and state institu-tions.

KANSAS MEDICAL ASSISTANCE PROGRAM Fee-for …
General Benefits Fee-for-Service Provider Manual for information on the plastic State of Kansas Medical Card and eligibility verification.

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In state fiscal year (FY) 2021, Medicaid and CHIP covered an average of 461,090 people in Kansas per month at a cost of $4.4 billion for the year, as shown in Figure 1. Expenditures for …

Ks Medicaid Fee Schedule (book) - netsec.csuci.edu
The KS Medicaid fee schedule is a crucial document that dictates the maximum amount the Kansas Medicaid program will reimburse healthcare providers for specific services rendered to …

Table of Contents State/Territory Name: Kansas State Plan …
titled “KMAP Fee Schedules.” To access a fee schedule: a. Select the program from the drop-down list -TXIX; b. Choose the type of rates – Medicaid; c. After choosing the rate type, the …

Table of Contents State/Territory Name: Kansas - Medicaid.gov
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 …

Kansas Medicaid Eligibility and Fee for Service Member -19 …
SEPTEMBER 2022. KMAP GENERAL BULLETIN 22246. Kansas Medicaid Eligibility and Fee for Service Member Ending the COVID-19 Public Health Emergency Temporary Waivers. y, the …

Table of Contents State/Territory Name: Kansas State Plan …
Kansas Department for Aging and Disability Services (KDADS) and must be licensed to operate in the Kansas State Medicaid program. Providers must be a not-for-profit organization or a part …