MedicaidCoverageMedium impact
KMAP BULLETIN: Coverage of Additional Sleep Study Diagnoses for Children
Kansas Medicaid (KanCare)·KS · Sleep Medicine, Pediatrics, Pulmonology·Medical Policy
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
KMAP (Kansas Medicaid) has expanded coverage for sleep studies in children aged 20 and younger by adding 8 new ICD-10 diagnosis codes effective July 1, 2024. These additional diagnosis codes are now covered for sleep study services, expanding billing opportunities for pediatric sleep studies.
Action Required
Immediately: Billing team should update system to allow billing of sleep study services for pediatric patients (20 years and younger) with newly covered ICD-10 codes G25.81, G47.00, G47.10, G47.61, G47.8, G47.9, R06.83, and Z93.0. Update encounter forms and inform providers that these diagnoses are now covered for Kansas Medicaid sleep studies. Note that MCO implementation dates may vary from the July 1, 2024 effective date.