MedicaidCoverageLow impact
KMAP BULLETIN: Registered Nurse Education Visits for Elevated Blood Lead Levels
Kansas Medicaid (KanCare)·KS · Pediatrics, Family Medicine·Provider Bulletin
Effective date
Oct 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now covers Registered Nurse education visits for children with elevated blood lead levels (≥5 mcg/dL) using code T1001 U1, reimbursed at $60 per visit. Coverage is limited to 4 visits per year and requires diagnosis code Z77.011 for billing.
Action Required
Immediately: Billing team must update system to recognize new coverage for HCPCS code T1001 with U1 modifier for Kansas Medicaid patients. Set reimbursement rate at $60.00 and add edit to require diagnosis code Z77.011. Configure annual limit of 4 visits per patient. Ensure place of service is limited to codes 12 (Home) or 71 (State/Local Public Health Clinic).