KMAP BULLETIN: Expansion of Providers for Community Psychiatric Support and Treatment
Date: 07/29/24
KMAP GENERAL BULLETIN 24159 (PDF)
Effective with dates of service on and after July 1, 2024, the Specialized Community-Based Rehabilitation Services of Community Psychiatric Support and Treatment (CPST) codes H0036-HA and H0036-HB may be billed by providers listed below. A physician or a Licensed Mental Health Professional (LMHP) who is acting within the scope of their professional license and applicable state law, shall determine the medical necessity of the service by conducting an assessment consistent with state law, regulation, and policy. Anyone providing substance abuse treatment services must be licensed in accordance with state law, in addition to their scope of practice license.
The following enrolled supervising Provider Types/Provider Specialties (PT/PS) will be allowed when billed as the rendering provider:
PT 09 - Advance Practice Nurse:
| Specialty | Description |
|---|---|
| 093 | Nurse Practitioner (Other) |
| 096 | Psychiatric Nurse Practitioner |
PT 10 - Mid-Level Practitioner:
| Specialty | Description |
|---|---|
| 100 | Physician Assistant |
PT 11 - Mental Health Provider:
| Specialty | Description |
|---|---|
| 108 | Licensed Master’s Level Psychologist (LMLP) |
| 109 | Licensed Clinical Psychotherapist (LCP) |
| 111 | Community Mental Health Center (CMHC) |
| 112 | Psychologist |
| 115 | LMHP |
| 116 | Licensed Clinical Mental Health Professional (LCMHP) |
| 121 | Certified Community Behavioral Health Clinic (CCBHC) |
| 123 | Children with Severe Emotional Disturbances |
| 125 | Home Based Family Therapy |
| 176 | Alcohol and Drug Rehabilitation |
PT 31 - Physician:
| Specialty | Description |
|---|---|
| 316 | Family Practitioner |
| 318 | General Practitioner |
| 339 | Psychiatrist |
| 348 | Addiction Medicine |
| 349 | Exempt License Physician |
Professional providers shall be:
- Licensed in their appropriate discipline.
- Enrolled in the Kansas Medical Assistance Program (KMAP).
- Review contract with the KanCare Managed Care Organization (MCO) as applicable.
- Complete training approved by the Kansas Department for Aging and Disability Services (KDADS) for CPST.
Non-licensed and paraprofessional providers shall complete the
required trainings as directed:
- Training approved by KDADS for non-licensed mental health service providers can be found on the KDADS website: a. Provider Trainings - State Training Requirements
- Trainings shall be completed as directed in state training requirements and documentation of trainings need to be accessible by the supervising professional.
The CPST services must be furnished by or under the direction of a physician. Each supervising licensed professional/enrolled entity should bill for the services provided as the rendering provider. CPST services shall follow the required components, provider qualifications, training requirements, and service limitations listed in the Mental Health Feefor-Service Provider Manual.
The CPST services provided at a work site must not be job tasks oriented. Any services or components of services, the basic nature of which are to supplant housekeeping, homemaking, or basic services for the convenience of a person receiving covered services (including housekeeping, shopping, childcare, and laundry services) are noncovered
Note: The effective date of the policy is July 1, 2024. The implementation of State policy by the KanCare 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.