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KMAP BULLETIN: Coverage for 92622 and 92623 When Billed with an AB Modifier

Date: 04/04/25

KMAP GENERAL BULLETIN 25016 (PDF)

Effective with dates of service on or after April 1, 2025, Kansas Medicaid will cover the following audiology services for ages 0-20 when submitted with the AB modifier and billed by the Provider Type/Provider Specialty (PT/PS) 20/200 (Audiologist):

 Procedure Code 
92622
92623

 

Billing and Coding Requirements:

  • Limited to non-acute hearing conditions and diagnostic services related to implanted auditory prosthetic devices.
  • Excludes audiology services that are related to disequilibrium, hearing aids, or examinations for the purpose of  prescribing, fitting, or changing hearing aids.
  • Covered once per member per 12-month period.
  • Unexpected discovery of an acute condition.

Note: The effective date of the policy is April 1, 2025. 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 the changes resulting from this provider bulletin, view the updated Audiology Feefor-Service Provider Manual, pages 8-8 and A-1; LEA Fee-for-Service Provider Manual, pages 8-7 and A-1; KBH Fee-for-Service Provider Manual, pages 8 and 17; and Professional Fee-for-Service Provider Manual, page 8-10.