KMAP BULLETIN: EPSDT Updates

Date: 10/01/18

KMAP GENERAL BULLETIN 18154 (PDF)

Effective with dates of service on and after November 1, 2018, modifier EP will be informational only. It can be used with any Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screening code but will no longer result in the bundled payment for an EPSDT screen. Providers will need to bill each service provided with the appropriate HCPCS code. For children receiving EPSDT services, any limits on services may be exceeded when medically necessary.

Further information is available in the KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Provider Manual on the Provider Manuals page of the Kansas Medical Assistance Program (KMAP) website.

Note: The effective date of the policy is November 1, 2018.

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, once the policy is implemented.

For the changes resulting from this provider bulletin, view the updated Coding Modifiers Table and KAN Be Healthy - Early and Periodic Screening, Diagnostic, and Treatment Fee-for-Service Provider Manual, Section 7000, page 7-1; and Section 8000, pages 8-3 to 8-7.