KMAP BULLETIN: Update to Cognitive Therapy Code Change on the BI Waiver

Date: 05/08/25

Effective with dates of service retroactive to February 1, 2024, the Home and Community Based Services – Brain Injury (HCBS-BI) waiver allows for the Cognitive Therapy codes (97537 and 97535) to be provided virtually using place of service codes 02 (Telehealth Provided Other than in Patients Home) or 10 (Telehealth Provided in Patients Home).

Service delivery must follow the approved Person-Centered Service Plan (PCSP), ensuring the appropriate combination of in-person and virtual services is based on individual needs and clinical
appropriateness.

The impacted claims will be identified and reprocessed.

Note: The effective date of the policy is February 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.

For changes resulting from this bulletin, view the updated General Benefits Fee-for-Service Manual, page 2-29.