KMAP BULLETIN: Rate Changes for Physician Administered Drugs - January 2024

Date: 12/22/23

KMAP HOSPITAL BULLETIN 23330 (PDF)

Effective with dates of service on and after January 1, 2024, Medicaid rates for some physician administered drugs (PADs) will be updated. Reimbursement for PADs is dependent on multiple factors. For the most current information and verification of coverage, access the Reference Codes-Search By Procedure under the Provider tab on the Kansas Medical Assistance Program (KMAP) public website or from the Provider Secure Portal under Pricing and Limitations.

Note: See each plan for guidance on billing and reimbursement for Managed Care members and drugs identified on the High Dollar Rare Disease (HDRD) list. Refer to the updated KMAP General Bulletin 23264 (PDF).

Note: The effective date of the policy is January 1, 2024. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the 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.