KMAP BULLETIN: Additional State Plan Services

Date: 06/14/17

KMAP GENERAL BULLETIN 17129

Effective with dates of service on and after January 1, 2017, three services which were previously covered under the Autism waiver are now covered as State Plan services under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provisions.

As previously published in General Bulletin 17064, the new State Plan services include Consultative Clinical and Therapeutic Services which should be performed by provider type 11 with specialty 403. The assessment function has been added under this service. The following codes are covered:

• 0359T
• 0360T
• 0361T

Coverage requires that a recommendation be made by a physician or other licensed practitioner and is subject to a prior authorization (PA) process.

Appropriate manual updates will be made at a later time, and providers will receive additional notification.

Note: The effective date of the policy is January 1, 2017. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates.