MedicaidBilling CodesHigh impact
Changes to EPSDT Therapy Billing Codes
Kentucky Medicaid·KY · Physical Therapy, Occupational Therapy, Pediatrics·Coding
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid is requiring EPSDT therapy providers to transition from billing S-codes (S9128, S9131, S9129) to appropriate 9-series CPT codes with specific modifiers (GN, GO, GP) starting January 1, 2026. The flat reimbursement rate of $85.05 per therapy type remains unchanged.
Action Required
By January 1, 2026: Billing team must update system to replace S-codes (S9128, S9131, S9129) with appropriate 9-series CPT codes from the Kentucky Medicaid fee schedule. Add required modifiers: GN for speech therapy, GO for occupational therapy, GP for physical therapy. Update encounter forms and train staff on new coding requirements for EPSDT therapy services.