Back to dashboard
MedicaidReimbursementMedium impact

KMAP BULLETIN: Pediatrician Rate Increase for Office Visit Codes

Kansas Medicaid (KanCare)·KS · Pediatrics·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Medicaid (KMAP) is increasing reimbursement rates for pediatrician office visit codes effective July 1, 2025. Nine common office visit CPT codes will have new higher payment rates, but only for providers with the specific Pediatrician specialty designation (31/345).

Action Required

Action needed
Before July 1, 2025: Billing team must verify provider specialty designations in KMAP system to ensure pediatricians are properly coded as Provider Type 31/Specialty 345 to receive the increased rates. Update fee schedules in billing system with new Kansas Medicaid rates for pediatric office visits. Monitor KanCare MCO implementation dates as they may differ from the state effective date.

Affected Billing Codes

99202
99203
99204
99205
99211
99212
99213
99214
99215