MedicaidReimbursementHigh impact
Psychoeducation Policy Update H2027 H0038
Kentucky Medicaid·KY · Psychiatry·Provider Letter
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid has updated policies for Psychoeducation (H2027) and Peer Support Services (H0038) effective January 1, 2025. The changes include reduced reimbursement rates for H2027 across all provider types, new annual unit limits (500 units for H2027, 800 units for H0038), and clarified billing restrictions including which providers can deliver services and when bundling applies.
Action Required
By January 1, 2025: Billing team must update fee schedules with new reduced H2027 rates by provider type and modifier. Configure system to track annual unit limits (500 units H2027, 800 units H0038) and block billing when limits reached without prior authorization. Add HQ modifier requirement for group H2027 services with 12-recipient maximum. Update billing rules to prevent H2027 billing on same days as day treatment, TRP, IOP, PHP, or residential services. Block H2027 billing for Peer Support Specialists, Community Support Associates, and Registered Behavior Technicians (modifiers U7 and UC).