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KMAP BULLETIN: HCBS Rate Changes for Fiscal Year 2025

Date: 06/13/24

KMAP General Bulletin 24116 (PDF)

Effective with dates of service on and after July 1, 2024, and for the state fiscal year (SFY) 2025, the fees for Home & Community Based Services (HCBS) and Managed Care Floor rates will increase.

The updated rates for HCBS reimbursement are listed below:

Frail Elderly (FE)

Procedure Code

SFY 2025 Rate*

Unit Definition

S5130

$6.83

15 min

S5125

$7.50

15 min

S5125 UA

$8.31

15 min

S5125 UD

$4.08

15 min

T2040 U2

$162.53

1 month

T2025

$108.50

6 to 12 hrs

 

Technology Assisted (TA)

Procedure Code

SFY 2025 Rate*

Unit Definition

T1000

$12.50

15 min

T1004

$4.98

15 min

T1019

$4.13

15 min

T2040 U2

$155.52

1 month

 

Intellectual/ Developmental Disabilities (I/DD)

Procedure Code

SFY 2025 Rate*

Unit Definition

T1019

$4.36

15 min

T1000 TD

$12.50

15 min

T1000

$12.50

15 min

S5125

$4.96

15 min

H2023

$10.00

15 min

 

HCBS/Brain Injury (BI)

Procedure Code

SFY 2025 Rate*

Unit Definition

T2040 U2

$155.52

1 month

S5125 U9

$4.88

15 min

S5125 UB

$4.10

15 min

T2025

$103.81

6 to 12 hrs.

 

Physical Disability (PD)

Procedure Code

SFY 2025 Rate*

Unit Definition

S5125 UA

$4.88

15 min

S5125 U9

$4.88

15 min

S5125 U6

$4.10

15 min

T2040 U2

$155.52

1 month

T2025

$103.81

6 to 12 hrs.

 

Autism (AU)

Procedure Code

SFY 2025 Rate*

Unit Definition

T2040 U2

$155.52

1 month

 

* 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.

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 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.