MedicaidAdministrativeHigh impact
KMAP BULLETIN: Pregnancy Related Services Previous MCO to Current MCO
Kansas Medicaid (KanCare)·KS · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Summary
Due to the transition from Aetna Better Health to other MCOs, providers must split pregnancy-related billing based on service dates around January 1, 2025. Services before this date bill to Aetna, while services after bill to the member's new MCO.
Action Required
Immediately: Billing team must identify all active pregnancy cases spanning January 1, 2025. Split claims by service date - bill Aetna Better Health for all antepartum visits, delivery, and postpartum visits performed before January 1, 2025, and bill the member's newly assigned MCO for remaining services. Only use OB global codes if ALL pregnancy services were completed before January 1, 2025. Reference the Professional Manual for appropriate billing codes.