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KMAP BULLETIN: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5)

Date: 10/01/25

KMAP GENERAL BULLETIN 25213 (PDF)

Effective with dates of service on or after January 1, 2026, the use of Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-5) can be applied to children from birth to five (5) years old. Clinicians are encouraged to complete ZERO-TO-THREE™ training approved by Kansas Department of Aging and Disability Services (KDADS) and the Kansas Department of Health and Environment (KDHE).  Training shall be made available for clinicians who evaluate and assess children for behavioral health concerns.

The following codes shall be used in the amount and frequency to thoroughly assess KAN Be Healthy (KBH) members, based upon members’ individual needs and abilities to participate in testing/assessment.

 Code  Rate 
 96112  $88.74 
 96113  $40.49 

 

Note: The rates noted in this bulletin are subject to future changes. Providers should check the Kansas Medical Assistance Program (KMAP) website for the most up-to-date rates.

DC:0-5 is a multiaxial classification system for mental disorders in early childhood, intended to provide an age-appropriate and developmentally informed approach to assessing mental health and developmental disorders in children from birth through five years old that focuses on the development and caregiving relationships as part of understanding context of behaviors. Use of DC: 0-5 is recognized as best practice by SAMHSA (Substance Abuse and Mental Health Services Administration) and CMS  (Center for Medicare and Medicaid Services). It includes:

  • 42 clinical disorders and clinical examples for infants in their first year of life and a diagnostic algorithm for each disorder.
  • Requires distress and functional impairment.
  • Groups disorders into clusters similar to DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).
  • A crosswalk to other nosology’s (ICD-10 and DSM-5).
  • The age range of birth to 5 years old.
  • Incorporates a family-relational element in Axis II.
  • Differential diagnosis and acknowledges the likelihood of comorbid conditions.

Note: The effective date of the policy is January 1, 2026. 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.