MedicaidReimbursementMedium impact
KMAP BULLETIN: Rate Changes for Physician Administered Drugs – July 2025
Kansas Medicaid (KanCare)·KS·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Summary
Kansas Medicaid is updating reimbursement rates for physician-administered drugs (PADs) to match Medicare Part B rates effective July 1, 2025. This affects all HCPCS codes for drugs given in physician offices, with special provisions for high-dollar rare disease drugs and contraceptive products.
Action Required
By July 1, 2025: Billing team must verify that billing system will accept updated Medicaid reimbursement rates for all physician-administered drugs using HCPCS codes. Monitor KanCare Open Claims Resolution Log on KMAP Bulletins page for MCO implementation dates which may differ from July 1st. Update fee schedules once MCOs confirm implementation to ensure proper reimbursement expectations.