Who is affected by this change?

This affects Kansas Medicaid (KanCare) Pediatrics, Psychiatry, Neurology providers in KS on Medicaid plans.

When does this change take effect?

This change is effective Apr 1, 2025.

Which billing codes are affected?

The following codes are affected: 96112, 96113.

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MedicaidCoverageMedium impact

KMAP BULLETIN: Developmental Testing Codes

Kansas Medicaid (KanCare)·KS · Pediatrics, Psychiatry, Neurology·Provider Bulletin

Effective date

Apr 1, 2025

We identified it

Jun 21, 2026

Days to comply

—

Summary

Kansas Medicaid (KMAP) is removing the 3-visit annual limit for developmental testing services effective April 1, 2025. CPT codes 96112 and 96113 can now be billed based on individual patient needs without frequency restrictions.

Action Required

Action needed

By April 1, 2025: Billing team must update system settings to remove the 3-visit annual limit for CPT codes 96112 and 96113 for Kansas Medicaid (KBH) members. Verify with KanCare MCO system status on KMAP Bulletins page before implementation as MCO timing may vary. Review updated provider manuals for any additional billing guideline changes.

Affected Billing Codes

96112

96113

Related policy hubs

Kansas Medicaid (KanCare) policies KS policy changes Pediatrics Psychiatry Neurology Code 96112 Code 96113