KMAP BULLETIN: Parent Peer Support

Date: 12/12/22

Effective with dates of service January 1, 2023, Parent Peer Support will be covered utilizing current code H0038, individual and group, and with the HQ modifier for group. Parent Peer Support providers must self-identify as a person with lived experience in raising a child with a Serious Emotional Disturbance (SED), Substance Use Disorder (SUD), or cooccurring mental health diagnosis.

There will be no age restrictions for the parent receiving services, however the standard of 3 years age difference between the parent and provider applies. The current providers will be allowed to add this service to their array of services. The identified member’s Medicaid ID number will be used for billing purposes. Group size is limited to a maximum of 8. This service cannot be billed if the identified member has an acute or residential level of care.

This service is covered, when based on clinical judgement, the member may not be present at the time the service is delivered, but the identified member remains the focus of the service. Parent Peer Support services involving the participation of a nonMedicaid eligible individual(s) must be documented in the medical record as having a direct benefit for the member. This documentation must demonstrate that the service is designed to address the identified member’s individual needs on the treatment plan and outlining the expected interventions and improvements in behavioral health. This service connects the parent/guardian with an individual with lived experience to guide and support the parent/guardian in advocating for their member.

A licensed clinical practitioner will determine that Parent Peer Support is necessary to be included in the patient’s treatment plan. When the member is an adult, his/her permission must be obtained in writing.

Note: The effective date of the policy is January 1, 2023. 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.