KMAP BULLETIN: Expanding Peer Support Providers
Date: 10/31/23
KMAP GENERAL BULLETIN 23275 (PDF)
Effective with dates of service retroactive to July 1, 2023, Peer Support services (individual or group) may be billed by any behavioral health services provider who is an enrolled Kansas Medicaid provider. Each supervising licensed professional should bill for the services of Peer Specialists, Peer Mentors, and Parent Peer Specialists.
Supervising professionals should complete the required Peer Support Supervisor Training and maintain all training records for professionals and Peer Specialists, Peer Mentors, and Parent Peer Specialists.
Persons providing peer support services and the organizations that employ them must provide peer support services in a manner consistent with the requirements set forth by the Kansas Department of Aging and Disability Services (KDADS) including required training. See Kansas Certified Peer Specialist Training.
This service cannot be billed if the identified member has an acute or residential level of care. There will be no change in the established reimbursement rates.
The following codes are utilized for billing Peer Support:
- H0038
- H0038 HQ
The following enrolled supervising Provider Type/Provider Specialties (PT/PS) will be allowed when billed as the performing provider:
Provider Type 09 - Advance Practice Nurse:
| Specialty | Description |
|---|---|
| 093 | Nurse Practitioner (Other) |
| 096 | Psychiatric Nurse Practitioner |
Provider Type 10 - Mid-Level Practitioner:
| Specialty | Description |
|---|---|
| 100 | Physician Assistant |
Provider Type 11 - Mental Health Provider:
| Specialty | Description |
|---|---|
| 108 | Licensed Master’s Level Psychologist (LMLP) |
| 109 | Licensed Clinical Psychotherapist (LCP) |
| 112 | Psychologist |
| 115 | Licensed Mental Health Professional (LMHP) |
| 116 | Licensed Clinical Mental Health Professional (LCMHP) |
| 121 | Certified Community Behavioral Health Clinic |
| 123 | Children with Severe Emotional Disturbances |
| 125 | Home Based Family Therapy |
| 176 | Alcohol and Drug Rehabilitation |
Provider Type 31- Physician:
| Specialty | Description |
|---|---|
| 316 | Family Practitioner |
| 318 | General Practitioner |
| 339 | Psychiatrist |
| 348 | Addiction Medicine |
| 349 | Exempt License Physician |
Note: The effective date of the policy is July 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.