KMAP BULLETIN: HCBS Assistive Services: Home & Environmental Modification Services, Vehicle Modification Services, Specialized Medical Equipment and Supplies Policy
Date: 07/18/25
KMAP GENERAL BULLETIN 25158 (PDF)
Effective with dates of service retroactive to April 1, 2024, Assistive Services were unbundled into three distinct services with unique billing codes under the Home and Community Based Services (HCBS) waiver programs for Brain Injury (BI), Frail Elderly (FE), Intellectual/Developmental Disability (IDD), and Physical Disability (PD), waivers. This policy outlines the principles and guidelines for accessing these important services for HCBS waiver recipients.
Assistive Services:
| Services | Billing Code |
|---|---|
| Home and Environmental Modification Services (HEMS) | S5165 |
| Vehicle Modification Services (VMS) | T2039 |
| Specialized Medical Equipment and Supplies (SMES) | T2029 |
Key Implementation Guidelines:
Eligibility and Access:
Assistive Services must be identified in the Person-Centered Service Plan (PCSP) and authorized by the Managed Care Organization (MCO). Assessment and discussion of needs should occur:
- At waiver initiation
- When the participant experiences a change in condition
- At participant request
- During PCSP reviews
Timely Evaluation:
- Needs must be evaluated within 14 business days of notification
- Facility discharge planning must begin no later than 30 days prior to discharge.
Spending Cap:
- Combined spending for HEMS, VMS, and SMES is capped at $10,000 per lifetime, per waiver (except for I/DD waiver participants).
- Exceeding this cap requires a Benefit Exception Report Form submitted by the MCO.
Provider Engagement and Oversight:
- Providers must deliver bids for HEMS within 10 business days of assessment.
- MCOs are responsible for oversight, documentation, and training related to assistive services.
Quality Assurance and Training:
- All services must be documented, functional, and affirmed by the participant and care team.
- Ongoing training and maintenance are essential components and may be accessed via State Plan or waiver services.
Grievance and Tribal Provisions:
- Participants may file grievances through the standard process or with the KanCare Ombudsman.
- Tribal participants may opt for direct service from a recognized Tribal provider with a separate provider agreement.
Action Required:
- All stakeholders must ensure they are following the revised policy procedures.
- MCOs must update staff training and procedures accordingly.
- Providers must ensure timely service delivery and documentation compliance.
For complete guidance on HCBS Assistive Services: HEMS, VMS, SMES policy – please refer to the official policy available under the “General” section on the Kansas Department for Aging and Disability Services (KDADS) website at KDADS Policies.
Note: The effective date of the policy is April 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 HCBS BI Fee-for-Service Provider Manual, pages 8-2, 8-4, and 8-5; HCBS FE Fee-for-Service Provider Manual, pages 8-3, 8-5, and 8-6; HCBS I/DD Fee-for-Service Provider Manual, pages 8-4 and 8-5; and HCBS PD Fee-for-Service Provider Manual, pages 7-2, 8-3, and 8-4.