MedicaidCoverageMedium impact
KMAP BULLETIN: Lead Hazard Risk Assessments – Local Health Departments Enrollment and Coverage
Kansas Medicaid (KanCare)·KS · Pediatrics, Family Medicine, General Practice·Medical Policy
Effective date
Oct 1, 2024
We identified it
Jun 21, 2026
Summary
Kansas Medicaid now allows Local Health Departments to enroll as providers and bill for lead hazard risk assessments for children 0-20 years with elevated blood lead levels ≥10 mcg/dL. New billing codes T1029 and T1029-U1 are available with specific frequency limits and prior authorization requirements.
Action Required
Immediately: Billing teams at Local Health Departments in Kansas must add new HCPCS codes T1029 ($600, once per year) and T1029-U1 ($150, twice per year) to billing systems for lead hazard assessments. Configure systems to require prior authorization for both codes and mandate primary diagnosis code R78.71. Update encounter forms to include confirmatory blood lead level requirement ≥10 mcg/dL from venous sample. Claims will be denied without proper prior authorization.