MedicaidCoverageMedium impact
KMAP BULLETIN: Codes E0561 and E0562 are Covered for Rental and Purchase
Kansas Medicaid (KanCare)·KS · Pulmonology, Sleep Medicine·Provider Bulletin
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now covers CPAP/BiPAP humidifier codes E0561 and E0562 for both rental and purchase, retroactive to July 1, 2024. Rental is limited to 10 months with prior authorization before automatic conversion to purchase, and purchase is limited to one unit per 730 days.
Action Required
Immediately: Billing team must update system to allow billing of E0561 and E0562 for Kansas Medicaid patients with appropriate rental ($6.58/$12.90) or purchase ($65.84/$128.85) rates. Ensure prior authorization workflows are in place for rentals and track 10-month rental limits. Update encounter forms to reflect new coverage. Resubmit any denied claims for these codes with dates of service from July 1, 2024 forward.