KMAP BULLETIN: Sleep Study Reimbursement Rates Clarification
Date: 04/15/25
KMAP GENERAL BULLETIN 25065 (PDF)
The reimbursement for the following sleep studies will continue to be reimbursed as outlined on Kansas Medicaid Assistance Program (KMAP) Provider Bulletin 24127. These rates were inadvertently impacted and reduced with the 2024 Medicaid Outpatient Rate increase policy.
This bulletin is to clarify that coverage and reimbursement of attended and unattended sleep studies will remain the same, and the impacted claims for the following codes will be reprocessed with the valid Medicaid rates.
| Code | Rate |
|---|---|
| 95805 | $434.08 |
| 95807 | $434.08 |
| 95808 | $846.75 |
| 95810 | $846.75 |
| 95811 | $846.75 |
As a reminder, the rates noted in this bulletin may change in the future. Providers should check the KMAP website for the most up-to-date rates.
Note: The effective date of the policy is July 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.