KMAP BULLETIN: Counseling Codes for EPSDT

Date: 12/18/20

KMAP GENERAL BULLETIN 20251 (PDF)

Effective with dates of service on or after January 1, 2021, the following codes will be covered for the KAN Be Healthy (KBH) population (TXIX and TXXI). Procedures 99401, 99402, 99403, and 99404 shall be used when reporting preventive medicine and/or risk factor reduction. Applicable coding guidelines, as stated in the American Medical Association's (AMA) Current Procedural Terminology (CPT) book, should be followed when using these evaluation and management (E/M) codes.

Note: The effective date of the policy is January 1, 2021. 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.