Kansas

Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

At A Glance
1 / 5

MEDICAID REIMBURSEMENT

  • Live Video: Yes
  • Store-and-Forward: No
  • Remote Patient Monitoring: Yes
  • Audio Only: Yes (Certified Community Behavioral Health Clinic (CCBHC) Services)

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: No

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: ASLP-IC, CC, EMS, IMLC, NLC, PSY, PTC
  • Consent Requirements: Yes

FQHCs

  • Originating sites explicitly allowed for Live Video:  Yes
  • Distant sites explicitly allowed for Live Video:  Yes
  • Store and forward explicitly reimbursed:  No
  • Audio-only explicitly reimbursed:  No
  • Allowed to collect PPS rate for telehealth:  No

STATE RESOURCES

  1. Medicaid Program: Kansas Medical Assistance Program
  2. Administrator: Kansas Dept. of Health and Environment
  3. Regional Telehealth Resource Center: Heartland Telehealth Resource Center
Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Last updated 03/04/2024

Definitions

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5).  (Accessed Mar. 2024).

Last updated 03/04/2024

Parity

SERVICE PARITY

Payment can be limited to only services that are medically necessary, subject to the terms and conditions of the covered individual’s health benefits plan.

SOURCE:  KS Statute Ann. § 40-2,213.  (Accessed Mar. 2024).


PAYMENT PARITY

Payment or reimbursement for covered services delivered through telemedicine may be established by an insurance company, nonprofit health service corporation, nonprofit medical and hospital service corporation or health maintenance organization in the same manner as payment or reimbursement for covered services that are delivered via in-person contact are established.

SOURCE:  KS Statute Ann. § 40-2,213. (Accessed Mar. 2024).

Last updated 03/04/2024

Requirements

Insurers cannot exclude an otherwise covered healthcare service from coverage solely because such service is provided through telemedicine, rather than in-person contact, or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider.

The insured’s medical record shall serve to satisfy all documentation for the reimbursement of all telemedicine healthcare services, and no additional documentation for telemedicine is required.

SOURCE:  KS Statute Ann. § 40-2,213.  (Accessed Mar. 2024).

The same requirements for patient privacy and confidentiality under the health insurance portability and accountability act of 1996 and 42 C.F.R. § 2.13, as applicable, that apply to healthcare services delivered via in-person contact shall also apply to healthcare services delivered via telemedicine. Nothing in this section shall supersede the provisions of any state law relating to the confidentiality, privacy, security or privileged status of protected health information.

Telemedicine may be used to establish a valid provider-patient relationship.

The same standards of practice and conduct that apply to health-care services delivered via in-person contact shall also apply to healthcare services delivered via telemedicine.

A person authorized by law to provide and who provides telemedicine services to a patient shall provide the patient with guidance on appropriate follow-up care.

SOURCE:  KS Statute Ann. § 40-2,212.  (Accessed Mar. 2024).

Last updated 03/04/2024

Definitions

Telemedicine is the use of communication equipment to link health care practitioners and patients in different locations. This technology is used by health care providers for many reasons, including increased cost efficiency, reduced transportation expenses, improved patient access to specialists and mental health providers, improved quality of care, and better communication among providers.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-31 (Jan. 2024); FQHC/RHC, p. 8-14 (Dec. 2023), (Accessed Mar. 2024).

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare.

‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. A physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5) & KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-32 (Jan. 2024). (Accessed Mar. 2024).

Telemedicine is the use of communication equipment to link health care practitioners and individuals in different locations.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Certified Community Behavioral Health Clinic (CCBHC), p. 8-5 (Jan. 2024). (Accessed Mar. 2024).

Last updated 03/04/2024

Email, Phone & Fax

Telemedicine does not include communication between:

  • A healthcare provider that consists solely of a telephone voice-only conversation, email, or facsimile transmission.
  • A physician and a patient that consists solely of an email or facsimile transmission.

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-32 & 2-33 (Jan. 2024). (Accessed Mar. 2024).

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14, (Dec. 2023). (Accessed Mar. 2024).

Hospital E&M

A “comprehensive exam” is considered a “hands on” specialist examination. Telephone consultation with a specialist is not the equivalent of comprehensive exam.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospital, p. 8-4 (Jan. 2024). (Accessed Mar. 2024).

Hospice

Providers can submit claims for SIA end of life care if the following criteria are met: … The service is not covered if provided by a social worker via telephone.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospice, (Nov. 2023). (Accessed Mar. 2024).

Certified Community Behavioral Health Clinic (CCBHC) Services

Telephone evaluation and management service provided by a qualified healthcare professional to an established patient, parent, or guardian. National coding guidelines specify the criteria for appropriately billing these three codes.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Certified Community Behavioral Health Clinic (CCBHC) Services, (Jan. 2024). (Accessed Mar. 2024).

COVID allowance for telephonic coverage for Consultative Clinical and Therapeutic Services (CCTS) and Intensive Individual Support (IIS), and Select Speech Therapy codes was discontinued effective May 11, 2023.

SOURCE:  KMAP General Bulletin 23118 (May 2023), & KMAP General Bulletin 23115 (May 2023), (Accessed Mar. 2024).

Last updated 03/04/2024

Live Video

POLICY

Insurers (including Medicaid) cannot exclude from coverage a service solely because the service is provided through telemedicine, rather than in-person contact or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider.

SOURCE: KS Statute Ann. § 40-2,213(b).  (Accessed Mar. 2024).

Services provided through telemedicine must be medically necessary and are subject to the terms and conditions of the individual’s health benefits plan.

Payment or reimbursement of covered healthcare services delivered through telemedicine is the payment or reimbursement for covered services that are delivered through personal contact.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.  2-32 & 33 (Jan. 2024). (Accessed Mar. 2024).


ELIGIBLE SERVICES/SPECIALTIES

Eligible services:

  • Office visits;
  • Individual psychotherapy;
  • Pharmacological management services.

The consulting or expert provider at the distant site must bill with the 02 place of service code and will be reimbursed at the same rate as face-to-face services. The GT modifier is not required when billing for telemedicine services.

See manual for list of acceptable CPT codes as well as codes KMAP does not recognize for payment.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-32 (Jan. 2024) & FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

Mobile Crisis Intervention (MCI):  Preference is for MCI to be provided in person, at the preferred location of the individual or family (home, school, or another community-based setting) by a LMHP. In situations where a face-to-face service by an LMHP is not viable, the medical record should reflect the reason that an LMHP was unable to respond to the crisis. If face-to-face by a clinician is not viable, the MCI in person contact could made by a peer, case manager, or other professional that would provide telemedicine access to an LMHP.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Mental Health, p. 8-29 (Jan. 2024). (Accessed Mar. 2024).

The speech-language pathologist and audiologist may furnish appropriate and medically necessary services within their scope of practice via telemedicine.  See manual for list of codes that are deemed appropriate to be furnished via telemedicine by the American Speech-Language and Hearing Association. Codes not appearing on the tables below are not covered via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Jan. 2024), & Rehabilitative Therapy Services, p. 8-4, (Jan. 2024). (Accessed Mar. 2024).

Kansas Medicaid does not authorize the use of telemedicine in the delivery of any abortion procedure.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-33 (Jan. 2024). (Accessed Mar. 2024).

Autism Service

Parent support and training as well as Family Adjustment Counseling can be provided via telemedicine, telehealth, or other modes of video distance monitoring methods that adhere to all required HIPPA guidelines and meet the state standards for telemedicine delivery methods.  This service delivery model is subject to state program manager approval. A request submitted for this exception must include, at a minimum, three written statements from service providers in at least a 50-mile radius declining to provide services because the participant resides in a location that is so remote or far away that the provider does not have the staff to meet with the child on a continual and/or intermittent basis as needed.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Autism Services, p. 8-5 & 8-9 (Aug. 2023). (Accessed Mar. 2024).

Intellectual/Developmentally Disabled Services

All functional assessments must be conducted in-person at a location of the individual’s choosing, or, if available, through the use of real-time interactive telecommunications equipment that includes, at a minimum, audio and video equipment. Those responsible for conducting the assessment will be flexible in accommodating the individual’s preference for the meeting location and time of assessment.

SOURCE: KS Dept. of Health and Environment, Provider Manual, HCBS Intellectual/Developmentally Disabled, p. I-1 (Mar. 2023). (Accessed Mar. 2024).

Substance Use Disorder directs providers to General Benefits manual telemedicine section.

SOURCE: KS Dept. of Health and Environment, Provider Manual, Substance Use Disorder, p. 8-10, (Mar. 2023), (Accessed Mar. 2024).

Stand-alone vaccine counseling may also be covered when provided via telehealth.

The face-to-face encounter [for home health] may occur through telehealth, as implemented by the State.

Telehealth and transportation codes are covered codes for OTP services. Please refer to the Kansas Medicaid Telehealth and Non-Emergency Medical Transportation (NEMT) policies.

SOURCE: KS Dept. of Health and Environment, Provider Manual, Professional, (Jan. 2024). (Accessed Mar. 2024).

Stand-alone vaccine counseling may also be covered when provided via telehealth.

SOURCE: KS Dept. of Health and Environment, Provider Manual, KAN Be Health EPSDT, (Dec. 2023), (Accessed Mar. 2024).

Prenatal Care At Risk Enhanced Care Coordination

Effective with dates of service on and after May 1, 2023, procedure code H1002 will be covered for telemedicine for video and audio transmissions. Existing provisions for the delivery of this service will remain in effect. Place of service (POS) code 10 (telehealth services provided in patient’s home) will be covered for code H1002.

SOURCE: KS Department of Health and Environment, KMAP Bulletin 23051, Prenatal Care At Risk Enhanced Care Coordination, Mar. 2023, (Accessed Mar. 2024).

Lactation Counseling

Effective with dates of service on or after April 1, 2023, lactation counseling services (utilizing procedure code S9443) for nonphysician lactation counselors will be additionally covered via telemedicine. Both video and audio transmissions will be covered. The home setting is allowed for this service delivery. Existing provisions for the delivery of this service will remain in effect until specifically rescinded.

Telemedicine Place of Service (POS) codes include:

  • 02 – Telehealth
  • 10 – Telehealth in patient home

SOURCE: KS Department of Health and Environment, KMAP Bulletin 23042, Lactation Counseling Via Telemedicine, Feb. 2023 & KS Dept. of Health and Environment, Provider Manual, Professional, (Jan. 2024). (Accessed Mar. 2024).

HCBS Appendix K

The service delivery options that will continue after November 11 include the following: …

A Remote Option for Receiving Services:

  • Members will be able to receive some in-home services through tele-video. The State is currently working to receive approval from the federal government for this. Managed Care Organization (MCO) Care Coordinators will provide members more information when this option is approved.

SOURCE: KMAP General Bulletin 23302 HCBS Appendix K – COVID Measure Rescinding (PHE Changes Ending), Nov. 2023, (Accessed Mar. 2024).

Non-Waiver Mental Health Attendant Care Service

Telehealth services are excluded from the EVV process for Non-Waiver Mental Health Attendant Care. Centers will continue to submit claims for Non-Waiver Mental Health Attendant Care until otherwise instructed.

SOURCE: KMAP General Bulletin 23326 Non-Waiver Mental Health Attendant Care Service Code – EVV Implementation Resuming, Dec. 2023, (Accessed Mar. 2024).


ELIGIBLE PROVIDERS

Telemedicine services may be delivered by a healthcare provider, which includes:

  • Physicians
  • Licensed Physician Assistants
  • Licensed Advanced Practice Registered Nurses
  • Or person licensed, registered, certified, or otherwise authorized to practice by the behavioral sciences regulatory board.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-31 (Jan. 2024), (Accessed Mar. 2024).

The speech-language pathologist and audiologist may furnish appropriate and medically necessary  services within their scope of practice via telemedicine. As documented in related telemedicine policies, telemedicine claims at the distant site must contain place of service 02 (Telehealth distant site).

  • Distant site means a site at which the healthcare provider is located while providing healthcare services by means of telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Jan. 2024),; Early Childhood Intervention Fee-for-Service Provider Manual, p. 8-5 (Feb. 2023); Local Education Agency Services, p. 8-7 (Feb 2023); & Rehabilitative Therapy Services, p. 8-4, (Jan. 2024). (Accessed Mar. 2024).

Providers who are not RHC or FQHC providers and are acting as the distant site will be reimbursed in accordance with a percentage of the Physician Fee Schedule and not an encounter rate.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14, (Dec. 2023), (Accessed Mar. 2024).


ELIGIBLE SITES

The speech-language pathologist and audiologist may furnish appropriate and medically necessary services within their scope of practice via telemedicine.  Providers at the originating site may submit claims using code Q3014 (Telehealth originating site facility fee).

  • Originating site means a site at which a patient is located at the time healthcare services are provided by means of telemedicine. The facilitator at the originating site must have the appropriate skill set to safely assist the speech-language pathologist or audiologist to provide safe, effective, and medically necessary services via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Jan. 2024), & Rehabilitative Therapy Services, p. 8-5, (Jan. 2024). (Accessed Mar. 2024).

Adding Place of Service Code 10 to Home Telehealth Nursing Services

Effective with dates of processing on and after January 1, 2022, licensed practical nurses (LPNs) or registered nurses (RNs) that provide home telehealth services must use Place of Service (POS) code 10 for codes T1030 and T1031 on all claims.

SOURCE: KS Department of Health and Environment, KMAP Bulletin 23033, Adding Place of Service Code 10 to Home Telehealth Nursing Services, Feb. 2023, (Accessed Mar. 2024).

Intensive Individual Support (IIS) Providers

Intensive Individual Support (IIS) providers may now bill under the following POS codes:…

  • 02 – Telehealth Provided Other Than in Patients Home
  • 10 – Telehealth Provided in Patients Home

See bulletin for other POS codes.

SOURCE: KS KMAP General Medicaid Bulletin 23211, Aug. 2023, (Accessed Mar. 2024).

CCBHC

The allowable Place of Service (POS) codes for HCPCS code H0040 are defined to provide clarity on coverage:

  • 02 – Telehealth Provided Other Than in Patients Home
  • 10 – Telehealth Provided in Patients Home

SOURCE: KS KMAP General Medicaid Bulletin 24005, Jan. 2024, (Accessed Mar. 2024).


GEOGRAPHIC LIMITS

No Reference Found


FACILITY/TRANSMISSION FEE

The originating site, with the member present, may bill code Q3014 with the appropriate POS code.  Providers at the originating site are required to submit claims using code Q3014 (Telehealth originating site facility fee).

Speech-Language Pathology

Originating site means a site at which a patient is located at the time healthcare services are provided by means of telemedicine. The facilitator at the originating site must have the appropriate skill set to safely assist the speech-language pathologist or audiologist to provide safe, effective, and medically necessary services via telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Jan. 2024), & Rehabilitative Therapy Services, p. 8-5, (Jan. 2024). (Accessed Mar. 2024).

RHC/FQHC

The originating site, with the member present, may bill code Q3014 with POS code 50 or 72 under the originating site provider ID and location number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, RHC/FQHC Fee-for-Service Provider Manual, Benefits & Limitations, p. 8-14 (Dec. 2023), (Accessed Mar. 2024).

Certified Community Behavioral Health Clinic (CCBHC) Services

The originating site, with the member present, may bill code Q3014 with the appropriate POS code. No payment will be made for Q3014 if the originating telemedicine site is place of service “home” (POS code 12) without the physical presence of a provider.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Certified Community Behavioral Health Clinic (CCBHC) Services, (Jan. 2024). (Accessed Mar. 2024).

Last updated 03/04/2024

Miscellaneous

The same requirements for patient privacy and confidentiality under HIPAA of 1996 and 42 C.F.R. §2.13, as applicable, that apply to healthcare services delivered through in-person contact also apply to healthcare services delivered through telemedicine. Nothing in this section supersedes the provisions of any state law relating to the confidentiality, privacy, and security or privileged status of protected health information (PHI).

  1. Telemedicine may be used to establish a valid provider-patient relationship.
  2. The same standards of practice and conduct that apply to healthcare services delivered through personal contact also apply to healthcare services delivered through telemedicine.
  3. A person who is authorized by law to provide and provides telemedicine services to a patient must provide the patient with guidance on appropriate follow-up care.
  4. Except when otherwise prohibited by any other provision of law, when the patient consents and has a primary care or other treating physician, the person providing telemedicine services will send within three business days a report to such primary care or other treating physician of the treatment and services rendered to the patient in the telemedicine encounter.
  5. A person licensed, registered, certified, or otherwise authorized to practice by the Behavioral Sciences Regulatory Board will not be required to comply with the provisions of requirement #4 (above).
  6. The provisions of this section shall also apply to the Kansas Medical Assistance Program (KMAP).
  7. KMAP will not exclude an otherwise covered healthcare service from coverage solely because such service is provided through telemedicine, rather than through personal contact, or based upon the lack of a commercial office for the practice of medicine.
  8. The insured’s medical record will serve to satisfy all documentation for the reimbursement of all telemedicine healthcare services, and no additional documentation outside of the medical record will be required.
  9. Payment or reimbursement of covered healthcare services delivered through telemedicine is the payment or reimbursement for covered services that are delivered through personal contact.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-32 (Jan. 2024). (Accessed Mar. 2024).

Home Health Agencies

The face-to-face encounter may occur through telehealth, as implemented by the State.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Home Health Agency, p. 8-7 (Feb. 2024). (Accessed Mar. 2024).

Hospice

Service Intensity Add-on (SIA) Payment for hospice care is not covered if provided by a social worker via telephone.

SOURCE:  KS Dept. of Health and Environment, Kansas Medical Assistance Program, FFS Provider Manual, Hospice, p. 8-11 (Nov. 2023). (Accessed Mar. 2024).

Last updated 03/04/2024

Out of State Providers

No reference found. See Cross-State Licensing Section under Professional Requirements.

Last updated 03/04/2024

Overview

Kansas Medicaid covers live video telemedicine for certain services.  Additionally, they also cover remote patient monitoring that is in real-time through home health agencies and with prior authorization.

Telephone evaluation and management services provided by a qualified healthcare professional to an established patient, parent, or guardian is reimbursed for certain codes.

All insurers (including Medicaid) must cover medically necessary services, subject to the terms and conditions of the contract. Medicaid specifically must provide reimbursement for speech language pathology services and audiology services.

Last updated 03/04/2024

Remote Patient Monitoring

POLICY

Kansas Medicaid will reimburse for home telehealth. The policy states:

“Home telehealth uses real-time, interactive, audio/video telecommunication equipment to monitor patients in the home setting, as opposed to a nurse visiting the home. This technology may be used to monitor the beneficiary for significant changes in health status, provide timely assessment of chronic conditions and provide other skilled nursing services.”

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. 8-29 (Feb. 2024) (Accessed Mar. 2024).

Home and Community Based Services for the Frail Elderly

“Home Telehealth is a remote monitoring system that enables the participant to effectively manage one or more diseases and catch early signs of trouble so intervention can occur before the participant’s health declines. The provision of Home Telehealth involves participant education specific to one or more diseases (e.g. COPD, CHF, hypertension, and diabetes), counseling, and nursing supervision.

SOURCE:  Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-17. (Mar 2023) (Accessed Mar. 2024).


CONDITIONS

Providers use codes T1030 and T1031 for the provision of telehealth visits under the Long-Term Care Home Health Service Plan and to assist members in managing their diabetes. See specific provider requirements for the provision of telehealth services.

Place of service 02 is used for home telehealth skilled nursing visits.  These codes are per visit.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, (Feb. 2024). (Accessed Mar. 2024).

Home and Community Based Services for the Frail Elderly

Telehealth services (including remote patient monitoring) are provided on an individualized basis for participants who have an identified need in their ISPOC. Participant options and information are provided and discussed during the development of the Integrated Service Plan of Care (ISPOC).

A participant can qualify if either of the following apply:

  • The participant is in need of disease management consultation and education AND has had two or more hospitalizations, including emergency room (ER) visits, within the previous year related to one or more diseases.
  • The participant is using MFP to move from a nursing facility back into the community.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-17 & 8-18, (Mar. 2023). (Accessed Mar. 2024).


PROVIDER LIMITATIONS

Home Telehealth services must be provided by a registered nurse or licensed practical nurse. Agencies may bill skilled nursing services on the same date of service as telehealth services.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, p. 8-29 (Feb. 2024). (Accessed Mar. 2024).

Home and Community Based Services for the Frail Elderly

Must be delivered by a registered nurse or licensed practical nurse with RN supervision.  Providers can include home health agencies or county health departments with system equipment capable of monitoring participant vital signs daily.  This includes (at a minimum) heart rate, blood pressure, mean arterial pressure, weight, oxygen saturation, and temperature. Also, the provider must have the capability to ask the participant questions which are tailored to his or her diagnosis. The provider and equipment must have needed language options such as English, Spanish, Russian, and Vietnamese.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-18-19, (Mar. 2023), (Accessed Mar. 2024).


OTHER RESTRICTIONS

Providers must submit literature to the fiscal agent’s Provider Enrollment team pertaining to the telecommunication equipment the agency has chosen that will allow thorough physical assessments such as: assessment of edema, rashes, bruising, skin conditions, and other significant changes in health status.

Providers must satisfy all the enrollment/demonstration requirements. See manual for specific demonstration criteria.

Providers are eligible for reimbursement of home telehealth services that meet the following criteria:

  • Prescribed by a physician or allowed nonphysician practitioner;
  • Considered medically necessary;
  • Signed beneficiary consent for telehealth services;
  • Skilled nursing service;
  • Does not exceed program limitations (two visits per week for non-Home and Community Based Services beneficiaries)

Providers must obtain prior authorization (PA) for member participation in the demonstration process, as PA is required for all fee-for-service home health visits.

Home Telehealth Limitations

  • Providers must bill T1030 and T1031 with place of service 02 for home telehealth skilled nursing visits. These codes are per visit.
  • PAs are entered for no more than 60 days. Home telehealth services cannot be approved for durations of more than 60 days. Additional documentation may be required to support continuation of home telehealth service requests that exceed 60 days.
  • Telehealth visits must be provided by a registered nurse or licensed practical nurse.
  • Telehealth visits must use face-to-face, real-time, interactive video contact to monitor beneficiaries in the home setting as opposed to a nurse visiting the home. This technology can be used to monitor a beneficiary’s health status and to provide timely assessments of chronic conditions and other skilled nursing services.
  • HCBS beneficiaries eligible for face-to-face skilled nursing visits provided by a home health agency may receive home telehealth visits with documentation of medical necessity and prior authorization (PA).  The PA must include units to cover the duration and frequency of home telehealth visits. Oral medication administration or monitoring is not considered skilled care.
  • Oral medication administration or monitoring is not considered skilled care.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health, (Feb. 2024). (Accessed Mar. 2024).

Home and Community Based Services for the Frail Elderly

See HCBS Frail Elderly provider manual for documentation requirements.

SOURCE:  Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, HCBS Frail Elderly, p. 8-19 & 8-20 (Mar. 2023), (Accessed Mar. 2024).

Last updated 03/04/2024

Store and Forward

POLICY

Kansas Medicaid requires the patient to be present at the originating site indicating store-and-forward will not be reimbursed, despite including store-and-forward in their definition of telemedicine.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-33 (Jan. 2024). (Accessed Mar. 2024).


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 03/04/2024

Cross State Licensing

Notwithstanding any other provision of law, a physician holding a license issued by the applicable licensing agency of another state or who otherwise meets the requirements of this section may practice telemedicine to treat patients located in the state of Kansas, if such physician receives a telemedicine waiver issued by the state board of healing arts. The state board of healing arts shall issue such a waiver within 15 days from receipt of a complete application, if the physician:

  • Submits a complete application that may include evidence in the form of an affidavit from an authorized third party that the applicant meets the requirements of this section in a manner determined by the state board of healing arts and pays a fee not to exceed $100; and
  • holds an unrestricted license to practice medicine and surgery in another state or meets the qualifications required under Kansas law for a license to practice medicine and surgery and is not the subject of any investigation or disciplinary action by the applicable licensing agency.

A physician practicing telemedicine in accordance with this subsection shall conduct an appropriate assessment and evaluation of the patient’s current condition and document the appropriate medical indication for any prescription issued.

Nothing in this section shall supersede or otherwise affect the provisions of K.S.A. 65-4a10, and amendments thereto, or K.S.A. 2020 Supp. 40-2,210 et seq., and amendments thereto.

Any person who receives a telemedicine waiver under the provisions of this section shall be subject to all rules and regulations pertaining to the practice of the licensed profession in this state and shall be considered a licensee for the purposes of the professional practice acts administered by the state board of healing arts.

A waiver issued under this section shall expire on the date of expiration established by the state board of healing arts unless renewed in the manner established by the state board of healing arts, including payment of an annual renewal fee not to exceed $100 and evidence that the applicant continues to meet the qualifications described in this section.

Notwithstanding any other provision of law to the contrary, a physician holding a license issued by the applicable licensing agency of another state may provide, without limitation, consultation through remote technology to a physician licensed in the state of Kansas.

An applicable healthcare licensing agency of this state may adopt procedures consistent with this section to allow other healthcare professionals licensed and regulated by such licensing agency to practice telemedicine within the scope of practice defined by Kansas law for such healthcare profession as deemed by such licensing agency to be consistent with ensuring patient safety.

Nothing in this section shall be construed to prohibit a licensing agency from denying an application for a waiver under this section if the licensing body determines that granting the application may endanger the health and safety of the public.

As used in this subsection, “telemedicine” means the delivery of healthcare services by a healthcare provider while the patient is at a different physical location.

SOURCE: KS Statute Sec. 65-28-135, (Accessed Mar. 2024).

Last updated 03/04/2024

Definitions

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:

    1. Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or
    2. a physician and a patient that consists solely of an email or facsimile transmission.

SOURCE:  KS Statute Ann. § 40-2,211(5). (Accessed Mar. 2024).

Home Health Agency Licensure

“Telehealth” means the use of information and communication technology while a patient is at one site and a qualified health professional is at another site so that clinical parameters and other clinical data can be sent to qualified health professionals overseeing the health care provided to the patient. This term is also known as “telemedicine,” “telemonitoring,” or “remote monitoring.”

SOURCE:  KS Administrative Regulation, Sec. 28-51-100, (Accessed Mar. 2024).

Last updated 03/04/2024

Licensure Compacts

Member of the Interstate Medical Licensure Compact.

SOURCE: Interstate Medical Licensure Compact. The IMLC. (Accessed Mar. 2024).

Member of Nurses Licensure Compact.

SOURCE:  Current NLC States and Status.  NCSBN. (Accessed Mar. 2024).

Member of the Psychology Interjurisdictional Compact

SOURCE: PSYPACT Compact, (Accessed Mar. 2024).

Member of the Audiology and Speech-Language Therapy Compact.

SOURCE: ASLP Compact Map, (Accessed Mar. 2024).

Member of Physical Therapy Compact.

SOURCE: PT Compact, Compact Map, (Accessed Mar. 2024).

Member of EMS Compact

SOURCE: Interstate Commission of EMS Personnel Practice, EMS Member States, (Accessed Mar. 2024).

Member of Counseling Compact

SOURCE: Counseling Compact, Map, (Accessed Mar. 2024).

* See Compact websites for implementation and license issuing status and other related requirements.

Last updated 03/04/2024

Miscellaneous

Within the limits of appropriations therefor, the university of Kansas medical center is hereby authorized to establish, maintain and operate a telemedicine communications system, subject to the approval by the executive chief information technology officer under K.S.A. 75-4709, and amendments thereto. The telemedicine communications system shall apply telecommunications technology to the practice of medicine through compressed, full-motion, high-resolution, two-way interactive video communication and information transfer over long distances within a medical setting.

STATUS: KS Statute Annotated Sec. 76-389, (Accessed Mar. 2024).

Last updated 03/04/2024

Online Prescribing

The same laws and regulations that apply to the prescribing of drugs, including controlled substances, by means of in-person contact shall apply to the prescribing of drugs, including controlled substances, by means of telemedicine.

SOURCE: KS Admin. Regs., Sec. 100-77-3. (Accessed Mar. 2024).

“Legitimate medical purpose,” when used regarding the dispensing of a prescription drug, means that the prescription for the drug was issued with a valid preexisting patient-prescriber relationship rather than with a relationship established through an internet-based questionnaire.

SOURCE: KS Admin. Regs., Sec. 68-2-20(2). (Accessed Mar. 2024).

Telemedicine may be used to establish a valid provider-patient relationship.

SOURCE:  KS Statute Ann. § 40-2,212(b). (Accessed Mar. 2024).

“Telepharmacy” means the practice of pharmacy by a pharmacist located in Kansas using telecommunications or other automations and technologies to deliver personalized, electronically documented, real-time pharmaceutical care to patients or their agents, who are located at sites other than where the pharmacist is located, including prescription dispensing and counseling and to oversee and supervise telepharmacy outlet operations.

A pharmacist shall be in attendance at the telepharmacy outlet by connecting to the telepharmacy outlet via computer link, video link and audio link or other functionally equivalent telecommunications equipment and shall be available to consult with and assist the pharmacy technician in performing activities.

Not later than January 1, 2023, the board shall adopt rules and regulations necessary to specify additional criteria for a managing pharmacy and telepharmacy outlet under this section, including, but not limited to:

Application requirements;

  • structural, security, technology and equipment requirements;
  • staffing, training and electronic supervision requirements;
  • inventory record keeping and storage requirements;
  • labeling requirements;
  • establishment of policies and procedures;
  • the number of telepharmacy outlets that may be operated by a supervising pharmacy;
  • use of automated dispensing machines; and
  • criteria for requesting exemptions or waivers from the requirements set forth in rules and regulations adopted under this subsection.

SOURCE: KS Statute Sec. 65-16, 130, (Accessed Mar. 2024).

Out-of-state physician practice

A physician practicing telemedicine in accordance with this subsection shall conduct an appropriate assessment and evaluation of the patient’s current condition and document the appropriate medical indication for any prescription issued.

SOURCE: KS Statute Ann. Sec. 65-28, 135, (Accessed Mar. 2024).

Last updated 03/04/2024

Professional Boards Standards

Board of Healing Arts

SOURCE: KS Admin. Regulations Sec. 100-77-1 to 3, (Accessed Mar. 2024).

Last updated 03/04/2024

Definition of Visit

A covered RHC or FQHC “visit” means a face-to-face encounter between a clinic/center patient and a clinic/center health care professional or practitioner (listed below) during which a covered RHC/FQHC service or dental service is rendered:

  • Physician
  • Physician assistant (PA)
  • Advanced practice registered nurse (APRN)
  • Nurse midwife
  • Dentist (for FQHCs only)
  • Clinical psychologist
  • Clinical social worker
  • Registered nurse (RN), for KBH-EPSDT nursing screen only, bill with modifier TD
  • Visiting nurse (if the conditions listed under “visiting nurse services” are fulfilled)
  • Registered dental hygienist, extended care permit (RDH ECP)

Encounters with more than one health professional, or multiple encounters with the same professional, on the same day constitute a single visit.

Just because a service is covered does not automatically mean it is a billable/covered visit.  If an encounter does not involve one of the above listed practitioners, it is not a covered RHC/FQHC visit and should not be billed.

If an examination of the patient is not performed during a face-to-face encounter, it does not constitute a covered RHC/FQHC visit and should not be billed. For example, a visit for the sole purpose of obtaining or renewing a prescription (need for which was determined previously) without a medical examination of the patient is not a covered encounter.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-3 to 4 (Dec. 2023), (Accessed Mar. 2042).

Visit. A “visit” shall mean face-to-face encounter between a center patient and a center health care professional as defined in K.A.R. 129-5-118. Encounters with more than one health professional or multiple encounters with the same health professional that take place on the same day shall constitute a single visit, except under either of the following circumstances:

  • The patient suffers an illness or injury requiring additional diagnosis or treatment after the first encounter.
  • The patient has a different type of visit on the same day, which may consist of a dental, medical, or mental health visit.

SOURCE: KS Admin. Regulation Sec. 129-5-118a, (Accessed Mar. 2024).

Last updated 03/04/2024

Eligible Distant Site

The consulting or expert provider at the distant site must bill an appropriate code from the list below with place of service (POS) 02 – Telemedicine and will be reimbursed at the same rate as face-to-face services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

See: KS Medicaid Live Video Eligible Providers

Last updated 03/04/2024

Eligible Originating Site

The originating site, with the member present, may bill code Q3014 with POS code 50 or 72 under the originating site provider ID and location number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

See: KS Medicaid Live Video Eligible Sites

Last updated 03/04/2024

Facility Fee

The originating site, with the member present, may bill code Q3014 with POS code 50 or 72 under the originating site provider ID and location number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

See: KS Medicaid Live Video Facility/Transmission Fee

Last updated 03/04/2024

Home Eligible

If the RHC or FQHC services are in a setting outside of the clinic, the appropriate POS code must be used. For example, if an RHC or FQHC service is provided in a skilled nursing facility (SNF), POS code 31 is applicable. If an RHC or FQHC service is provided in the home, POS code 12 is applicable. Code 13 is the billable POS code for assisted living facilities.

If the service is furnished at a location other than the facility (such as the patient’s place of residence, the scene of an accident), the coverage as an RHC/FQHC encounter depends on whether there is an agreement that the clinic/center would compensate the practitioner for furnishing services in a location away from the clinic/center. The following criteria apply for billing for these services:

  • Practitioner Compensated: The service is covered as an RHC/FQHC visit and should only be billed under the RHC/FQHC provider number. It may not be billed under any other Medicaid provider number.
  • Practitioner Not Compensated: The service is not covered as an RHC/FQHC visit. It can be billed under the performing provider’s individual Medicaid provider number.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-4 & 8-6 (Dec. 2023), (Accessed Mar. 2024).

Federally qualified health center services provided at a location other than a federally qualified health center shall meet the following conditions:

  • No services are provided at an inpatient hospital, outpatient hospital, or hospital emergency room.
  • The services provided are listed in subsection (b).
  • The services are provided to a patient of a federally qualified health center.
  • The health professional providing the services is an employee of a federally qualified health center or under contract with a federally qualified health center and is required to seek compensation for that person’s services from the federally qualified health center.

SOURCE: KS Admin. Regulation Sec. 129-5-118, (Accessed Mar. 2024).

Last updated 03/04/2024

Modalities Allowed

Live Video

Office visits, individual psychotherapy, and pharmacological management services may be reimbursed when provided through telecommunication technology. The consulting or expert provider at the distant site must bill an appropriate code from the list below with place of service (POS) 02 – Telemedicine and will be reimbursed at the same rate as face-to-face services.  See manual for eligible codes.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

See: KS Medicaid Live Video


Store and Forward

The member must be present at the originating site, excluding store-and-forward modality.

See: KS Medicaid Store and Forward


Remote Patient Monitoring

Not mentioned in FQHC manual, although reimbursed in other KS Medicaid programs.

See: KS Medicaid Remote Patient Monitoring


Audio-Only

Email, telephone, and facsimile transmissions are not covered as telemedicine services.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

See: KS Medicaid Email, Phone and Fax

Last updated 03/04/2024

Patient-Provider Relationship

No reference found.

Last updated 03/04/2024

PPS Rate

Providers who are not RHC or FQHC providers and are acting as the distant site will be reimbursed in accordance with a percentage of the Physician Fee Schedule and not an encounter rate.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-14 (Dec. 2023), (Accessed Mar. 2024).

Last updated 03/04/2024

Same Day Encounters

Encounters with more than one health professional, or multiple encounters with the same professional, on the same day constitute a single visit.

Just because a service is covered does not automatically mean it is a billable/covered visit.

If the patient suffers illness or injury subsequent to the first visit on the same day requiring additional diagnosis and treatment which are different from the first visit, the second encounter qualifies as an additional visit.

Subsequent visit on the same day must be medically necessary and include documentation of why the subsequent service could not have been provided during the initial encounter.

SOURCE: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, FQHC/RHC, 8-4 (Dec. 2023), (Accessed Mar. 2024).