Kansas Billing Guide for Mental Health Therapists and Psychiatrists
Who pays, where to enroll and which rules change your claims in Kansas, for psychotherapists and psychiatric prescribers.
Last checked October 25, 2026. Reviewed against the official sources listed at the bottom of this page.
This Kansas billing guide covers Medicaid, Medicare, Blue Cross, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Kansas billing guide: how Kansas pays for outpatient care
The Kansas Department of Health and Environment (KDHE) runs Kansas Medicaid, which operates as KanCare. Most KanCare members are served by three managed care organizations (MCOs) under contracts running January 1, 2025 through December 31, 2027: Sunflower Health Plan, UnitedHealthcare Community Plan of Kansas and Healthy Blue Kansas; Aetna Better Health of Kansas stopped serving members on January 1, 2025.
Providers enroll once through KMAP (Kansas Medical Assistance Program, fiscal agent Gainwell Technologies), and KMAP fee-for-service claims must reach KMAP within 12 months of the date of service. Sunflower and Healthy Blue set a 180-day initial claim limit. Blue Cross and Blue Shield of Kansas (Topeka) and Blue Cross and Blue Shield of Kansas City (Blue KC, Johnson and Wyandotte counties) are separate independent Blue licensees, and Medicare Part B is handled by WPS (Jurisdiction 5).
Who to bill, at a glance
| Payer type | Who you bill | Where to enroll or check rules |
|---|---|---|
| Medicaid | KanCare (Kansas Medicaid and CHIP managed care), with KMAP fee-for-service for populations outside the MCOs: Kansas Department of Health and Environment (KDHE), Division of Health Care Finance, with KDADS | Provider enrollment |
| Medicare Part B | Wisconsin Physicians Service Government Health Administrators (WPS GHA) | CMS MAC page |
| Blue Cross Blue Shield | Blue Cross and Blue Shield of Kansas (BCBSKS), Topeka; Blue Cross and Blue Shield of Kansas City (Blue KC); Healthy Blue Kansas (Community Care Health Plan of Kansas, Inc.) | See the Blue Cross section below |
Kansas Medicaid and how to bill it
This Kansas billing guide starts with Medicaid, because it decides who pays and how you file.
Managed care. KDHE selected three MCOs (Sunflower Health Plan, UnitedHealthcare Community Plan and new entrant Healthy Blue) for a contract period of January 1, 2025 through December 31, 2027. KanCare's FAQ says providers must bill the KanCare MCO the member is enrolled in and obtain any required authorization.
KanCare's provider page says each MCO works with subcontractors for Behavioral Health, Dental, NEMT, Pharmacy and Vision.
| Item | What to know |
|---|---|
| Agency | Kansas Department of Health and Environment (KDHE), Division of Health Care Finance, with KDADS |
| Claims or fiscal agent | Gainwell Technologies is named as the fiscal agent for KMAP on KMAP bulletins and training materials. KMAP provider customer service: 800-933-6593 (KanCare FAQ). KanCare MCO members: bill the member's MCO, not KMAP. |
| Provider enrollment | Official enrollment page |
| Manual or fee schedule | Official provider resources |
| Provider portal | Provider portal |
Managed-care plans and carve-outs
| Plan or entity | Role in behavioral health |
|---|---|
| Sunflower Health Plan | Provider Services 877-644-4623; Medical payer ID 68069, Behavioral Health payer ID 68068 (Quick Reference Guide dated 5/2/2025, KDHE-approved). |
| UnitedHealthcare Community Plan of Kansas | Provider Services Call Center 877-542-9235. |
| Healthy Blue Kansas (Community Care Health Plan of Kansas, Inc.) | New KanCare MCO from 2025. Provider Services 833-838-2595; Availity payer ID 00047. |
Timely filing: KMAP fee-for-service claims must be received within 12 months of the date of service (KMAP General Billing manual, updated March 2018; repeated in a June 25, 2025 Gainwell training for KanCare).
Medicare Part B in Kansas
For Medicare, this Kansas billing guide names your contractor and the current telehealth rules.
As of 2026-10-25, per CMS Telehealth FAQ (updated 10/8/26): Medicare telehealth flexibilities run through December 31, 2027, including audio-only at home.
| Item | What to know |
|---|---|
| Contractor | Wisconsin Physicians Service Government Health Administrators (WPS GHA) |
| Jurisdiction | A/B MAC Jurisdiction 5 (J5): Iowa, Kansas, Missouri, Nebraska. |
| Source | CMS.gov MAC page |
Blue Cross Blue Shield in Kansas
This part of the Kansas billing guide names the exact Blue Cross licensee, because Blue plans never share rules.
Blue Cross Blue Shield is a federation of independent companies, so one licensee's rules never apply to another. Here is who holds the Blue license in Kansas.
| Licensee | Parent or affiliation | Where it applies | Provider resources |
|---|---|---|---|
| Blue Cross and Blue Shield of Kansas (BCBSKS), Topeka | Blue Cross Blue Shield Association licensee | Kansas | Source |
| Blue Cross and Blue Shield of Kansas City (Blue KC) | Blue Cross Blue Shield Association licensee | Johnson and Wyandotte counties are the only Kansas counties served (Provider Reference Guide, released September 14, 2026). | Source |
| Healthy Blue Kansas (Community Care Health Plan of Kansas, Inc.) | Self-described independent licensee of the Blue Cross Blue Shield Association; Medicaid (KanCare) product only. | KanCare statewide MCO. | Source |
Other private payers and EAPs in Kansas
The Kansas billing guide also covers commercial plans and employee assistance programs.
These commercial payers and plan families most often matter for behavioral health billing in Kansas. Check each payer's current provider manual before you submit.
| Payer | Behavioral health note | Provider resources |
|---|---|---|
| UnitedHealthcare / Optum Behavioral Health | UHC commercial 'General provider assistance' 877-842-3210 and 24/7 behavioral health and substance use support line 877-614-0484 (UHC national contact page). | Official page |
| Cigna / Evernorth Behavioral Health | Cigna provider contact page lists 800.88Cigna (882.4462) for telephone transactions and credentialing and 800.926.2273 for Evernorth Behavioral Health. | Official page |
| Aetna (commercial) | Aetna commercial providers: 1-888-MD Aetna (632-3862) for indemnity and PPO-based plans. | Official page |
Kansas billing guide: state law that changes billing
Use this section of the Kansas billing guide to separate state law from payer policy.
State law sets the floor for commercial plans in Kansas. Medicare and Medicaid rules are covered in their own sections above.
Mental health parity
K.S.A. 40-2,105 (individual and small employer group policies) requires coverage of mental illness, alcoholism, drug abuse and substance use disorder treatment, including at least 45 inpatient days per year, with the same deductibles, copayments, coinsurance, out-of-pocket expenses and treatment limitations as other covered services. Citation: K.S.A. 40-2,105; K.S.A. 40-2,105a. Source
Telehealth coverage and payment parity
K.S.A. 40-2,213 (L. 2018, ch. 98, effective July 1, 2018 per history line) applies to health insurance policies delivered, issued, amended or renewed on or after January 1, 2019, and to the Kansas medical assistance program. A covered plan may not exclude an otherwise covered service solely because it is delivered through telemedicine. The insured's medical record satisfies reimbursement documentation. Citation: K.S.A. 40-2,211; K.S.A. 40-2,213. Source
Prompt payment and timely filing
Kansas Health Care Prompt Payment Act (K.S.A. 40-2442): an accident and sickness insurer must pay a clean claim within 30 days of receipt or send written or electronic notice of status, denial reasons or the information needed. After receiving requested information it has 15 days to pay or deny. Late action triggers interest of 1% per month on the unpaid amount. Citation: K.S.A. 40-2442; KMAP General Billing manual (3/2018). Source
Practitioner scope: therapists and prescribers
KanCare requires providers joining an MCO to apply through the KMAP Provider Enrollment Wizard, and Healthy Blue states KMAP approval does not guarantee network participation. Source
Not legal advice. Confirm statute details with counsel.
Kansas billing guide: codes and rates
This Kansas billing guide lists only codes and rates confirmed on official pages.
These are the Kansas-specific codes, modifiers and rate items confirmed on official pages.
| Code or item | What to know |
|---|---|
| MCO reimbursement floor vs fee-for-service | KanCare's provider page says in-plan providers must receive at least 100% of the current fee-for-service Medicaid rate (as of 11/9/12) and that the rate cannot decrease during the KanCare contracts; out-of-network providers receive 90% of fee-for-service rates. Source |
| Corrected and replacement claims (Healthy Blue) | For corrected electronic claims use frequency code 7, replacement of prior claim; corrected claims or rebilling have a 365-day limit from date of service (June 2026 manual). Source |
| MCO claim disputes | Healthy Blue: reconsideration within 120 calendar days (plus 3 days for mailing) and appeal within 60 calendar days of the Notice of Action (plus 3 days). Source |
Kansas billing guide: what changed, newest first
Check this Kansas billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2026-10-08 | CMS Telehealth FAQ updated: Medicare telehealth flexibilities through 12/31/2027; in-person requirement for mental health telehealth after 12/31/2027. | Source |
| 2026-09-14 | Blue KC released its 2026 Provider Reference Guide; it lists Johnson and Wyandotte counties as the only Kansas counties served and Lucet-administered behavioral health. | Source |
| 2026-06-01 | Healthy Blue Kansas KanCare provider manual cover dated June 2026: 180-day timely filing, 365-day corrected claims, behavioral health prior authorization via Availity. | Source |
| 2026-02-27 | Sunflower Health Plan provider manual current as of February 27, 2026 (KDHE approved). | Source |
| 2025-06-03 | Healthy Blue Claims Timely Filing policy reviewed with no changes; 180 days for participating and nonparticipating providers, effective 1/1/2025. | Source |
| 2025-05-02 | Sunflower Quick Reference Guide dated 5/2/2025 (KDHE-approved): 180-day claims limit, 365-day corrected claims, payer IDs 68069 and 68068. | Source |
How do I bill mental health claims in Kansas?
These answers come from the same sources as the rest of this Kansas billing guide.
The Kansas Department of Health and Environment (KDHE) runs Kansas Medicaid, which operates as KanCare. Most KanCare members are served by three managed care organizations (MCOs) under contracts running January 1, 2025 through December 31, 2027: Sunflower Health Plan, UnitedHealthcare Community Plan of Kansas and Healthy Blue Kansas; Aetna Better Health of Kansas stopped serving members on January 1, 2025. Start with the member's payer type: Medicaid plan, Medicare Part B, a Blue Cross licensee or another commercial plan.
Questions about billing in Kansas
Who runs Medicaid in Kansas and who do I bill?
KDHE runs Kansas Medicaid as KanCare. Most members are enrolled in one of three MCOs: Sunflower Health Plan, UnitedHealthcare Community Plan of Kansas or Healthy Blue Kansas. KanCare's FAQ says to bill the MCO the member is enrolled in and get any required authorization from that plan.
How long do I have to file KanCare and Medicaid claims in Kansas?
KMAP fee-for-service claims must be received within 12 months of the date of service. Sunflower and Healthy Blue each set 180 days for initial claims, and both allow corrected claims for up to 365 days (Sunflower from the EOP date, Healthy Blue from the date of service). File early, because MCO limits are much shorter than the KMAP limit.
Is Aetna still a KanCare plan?
No. Aetna Better Health of Kansas stopped serving KanCare members on January 1, 2025, and its bulletin says claims with dates of service on or after that date are rejected except for specified inpatient stays. Aetna's commercial plans are separate.
Which Blue plan covers which part of Kansas?
Blue Cross and Blue Shield of Kansas (Topeka) and Blue Cross and Blue Shield of Kansas City (Blue KC) are separate independent licensees. Blue KC's 2026 guide says it serves only Johnson and Wyandotte counties in Kansas. Healthy Blue Kansas is a KanCare Medicaid plan, not a commercial Blue plan.
Does MCM South bill for practices in Kansas?
MCM South currently serves ten states; request a quote to ask about Kansas.
Sources for the Kansas billing guide
Last checked October 25, 2026. Every source below was opened and read on that date.
- CMS Telehealth FAQ updated 10/8/26, checked October 25, 2026
- KDHE: MCO selection announcement (May 14, 2024), checked October 25, 2026
- KanCare providers page, checked October 25, 2026
- KanCare provider FAQ, checked October 25, 2026
- KanCare appeals and grievances, checked October 25, 2026
- KDHE KanCare eligibility guidelines, checked October 25, 2026
- Gainwell/KDHE KMAP training deck (6/25/2025), checked October 25, 2026
- Aetna Better Health of Kansas close-out bulletin, checked October 25, 2026
- Sunflower Quick Reference Guide (5/2/2025), checked October 25, 2026
- Sunflower provider manual (2/27/2026), checked October 25, 2026
- Healthy Blue Kansas quick contact guide, checked October 25, 2026
- Healthy Blue claims timely filing policy, checked October 25, 2026
Related guides
Billing in Kansas? Let us handle the payer calls.
MCM South bills only mental and behavioral health, for psychotherapists and psychiatrists, in solo and medium-size practices. We currently serve ten states; request a quote to ask about Kansas.
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