KMAP BULLETIN: Immunization Administration by Pharmacy Providers

Date: 04/16/24

Effective with date of service on and after June 1, 2024, all pharmacy vaccine and vaccine administration services under Durable Medical Equipment (DME) will no longer be allowed and should instead be submitted on a professional claim using the following provider type/specialties:

Pharmacy (32/240) provider National Provider Identifier (NPI) as the billing provider.
Pharmacist (32/276) provider NPI as the performing (rendering) provider.

Note: Effective June 1, 2024, the current billing provisions under DME (25/255) will be discontinued and providers will no longer be allowed to bill vaccines under the DME benefit nor influenza vaccines through the pharmacy benefit.

Note: The effective date of the policy is June 1, 2024. 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.