Agency 30, Article 5 — PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND

(Authorized by K.S.A. 39-709, K.S.A. 1975Supp.39-708c;effectiveJan.1,1967;amend- ed Jan. 1, 1968; amended Jan. 1, 1969; amend- ed, E-70-9, Dec. 4, 1969; amended Jan. 1, 1971; amended Jan. 1, 1974; revoked May 1, 1976.)

(Authorized by K.S.A. 1967 Supp. 39-708; effective Jan. 1, 1967; amended Jan. 1, 1968; revoked Jan. 1, 1971.) 30-5-11 and 30-5-12. (Authorized by K.S.A. 1965 Supp. 39-708; effective Jan. 1, 1967; revoked Jan. 1, 1971.)

Scope of dental services. (a) Dental services shall be covered for recipients re- ceiving a Kan Be Healthy dental screening. (1) Both a Kan Be Healthy medical screening and a Kan Be Healthy dental screening shall be required for coverage of limited orthodontia ser- vices, with th…

Reimbursement for dental services. Reimbursement shall be made on the basis of reasonable charges, except no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for computa- tions. The sum of payments per Kan Be Healthy recipient for dent…

(Authorized by and implementing K.S.A. 1996 Supp. 39-708c; effective May 1, 1981; amended May 1, 1983; amended, T-84-11, July 1, 1983; amended May 1, 1984; amended, T-85-9, April 11, 1984; amended May 1, 1985; amend- 64 DEPARTMENT FOR CHILDREN AND FAMILIES 30-5-101a ed May 1, 198…

(Authorized by and implement- ing K.S.A. 1985 Supp. 39-708c; effective May 1, 1981; amended May 1, 1983; amended May 1, 1986; amended, T-87-5, May 1, 1986; amended May 1, 1987; revoked Dec. 27, 2002.)

Scope of optometric and op- tical services. Optometric and optical services shallbecoveredformedicaidrecipients.(a)These services shall include the following: (1) Optometric examinations; (2) medical treatment pursuant to K.S.A. 65- 1501, and amendments thereto; (3) grinding and …

Reimbursement for opto- metric and optical services. Reimbursement for covered services shall be made on the basis of reasonable charges, except no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for computations. (Authorized by and i…

Scope of podiatric services. Podiatric services shall be covered for Kan Be Healthy program participants. (a) Covered ser- vices shall be diagnosis and the manual, medical, surgical or pharmaceutical treatment of those parts of the body below the ankle. Diagnosis and treatment of…

Reimbursement for podiatric services. Reimbursement for covered services shall be made on the basis of reasonable charges, except that a fee in excess of the range maximum shall not be paid. (Authorized by and implement- ing K.S.A. 1985 Supp. 39-708c; effective May 1, 1981; amend…

Scope of psychological ser- vices. Psychological services shall be covered for medicaid recipients when provided by clinical psychologists who are licensed by the behavioral sciences regulatory board. (a) Psychotherapy ser- vices shall be limited to 40 hours per calendar year for…

Reimbursement for psychol- ogists services. Reimbursement shall be made on the basis of reasonable charges, except no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for compu- tations. (Authorized by and implementing K.S.A. 1980 Supp…

Scope of hearing services. Hearing services shall be covered for medicaid re- cipients. (a) Medical diagnosis, audiological test- ing, and the fitting and dispensing of hearing aids and appropriate accessories shall be covered. (b) A medical diagnosis shall be made by an ear spec…

Reimbursement for hearing services. Reimbursement for hearing services and for the fitting and dispensing of hearing aids, accessories, and follow-up service shall be made on the basis of reasonable charges, except that a fee in excess of the range maximum shall not be paid. The …

Scope of ambulance services. (a) General provisions of coverage. Ambulance services shall be available to program recipients. Services shall include the following: (1) emergency transportation to a facility where medical services will be rendered; and (2) non-emergency transporta…

Reimbursement for ambu- lance services. Reasonable fees as related to customary charges shall be paid for ambulance services. However, no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for computations. (Authorized by and implementin…

Scope of non-emergency medi- caltransportationservices.(a)Non-commercial transportation, including wheelchair transporta- tion, to and from medicaid-covered services, shall require prior authorization except for trips to re- ceive emergency care. Services shall be provided only w…

Reimbursement for non- emergency medical transportation services. (a) Non-commercial, non-emergency medical transportation providers shall be paid 22 cents per mile. (b) Each commercial, non-emergency medical transportation provider shall be reimbursed at one of the following rat…

(Authorized by and implementing K.S.A. 39-708c; effective May 1, 1981; amended May 1, 1983; amended, T-84-26, Oct. 19, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1986; amended Jan. 2, 1989; amended July 1, 1989; amended May 1, 2001; re- voked Nov. 17, 2006.)

Reimbursement for durable medical equipment, medical supplies, or- thotics, and prosthetics. (a) Reimbursement for covered services shall be made on the basis of rates established by the secretary. (b) Reimbursement for used equipment or re- pairs of equipment shall not exceed 75…

Scope of services in freestand- ing inpatient psychiatric facilities. (a) Services shall be available to program recipients who are 65 and over if the services are provided by a facili- ty that meets the medicare requirements. (b) Services shall be available to program recip- ien…

Reimbursement for free- standing psychiatric facilities. Reimbursement 67 30-5-113a Medicaid Program for free-standing psychiatric facilities shall be pursuant to K.A.R. 30-5-81b as a general hospital. The effective date of this regulation shall be Oc- tober 1, 1993. (Authorized …

Scope of partial hospitalization programs. (a) Partial hospitalization services shall be provided in a community mental health center or a facility affiliated with a community mental health center. The only exception to this is “Kan Be Healthy” program participants who may receiv…

Reimbursement for partial hospitalization programs. Reasonable fees as related to customary charges shall be paid for par- tial hospitalization program services, except no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for computatio…

This rule and regulation shall expire on January 2, 1991. (Authorized by and implementing K.S.A. 1985 Supp. 39-777, 39-778; effective, T-84-25, Oct. 1, 1983; effective May 1, 1984; amended May 1, 1986; amended, T-30-12- 28-89, Jan. 1, 1990; amended, T-30-2-28-90, Feb. 28, 1990; r…

Scope of local health depart- ment services. (a) Local health department services shall be covered for medicaid/medikan recipients. (b) Covered services shall include the following: (1) Kan Be Healthy program services; (2) family planning services; (3) maternal and child health s…

Reimbursement for local health department services. Reasonable fees, as related to customary charges, shall be paid for local health department services, except that no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for computations …

Scope of advanced registered nurse practitioner and registered nurse anes- thetist services. (a) Advanced registered nurse practitioner services shall be covered for medicaid/ medikan recipients when provided by an advanced registered nurse practitioner who is certified pur- suan…

Reimbursement for ad- vanced registered nurse practitioner and registered nurse anesthetist services. The maximum rate for a service provided by an ad- vanced registered nurse practitioner or a regis- tered nurse anesthetist shall be one of the follow- ing: (a) When the services …

Scope of targeted case man- agement services. (a) Targeted case manage- ment services shall be covered for medicaid/ medikan recipients. (b) Covered services shall include the following: (1) Referral for assessment; (2) referral for treatment if appropriate accord- ing to the ass…

Reimbursement for targeted case management services. Reasonable fees as related to customary charges shall be paid for targeted case management services, except no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for compu- tations. (A…

Scope of hospice services. Hospice services shall be covered for medicaid and medikan recipients who have been deter- mined to be terminally ill by a physician and who have filed an election statement with a hospice enrolled to participate in the medicaid/medikan program. Hospice…

Reimbursement for hospice services. Reasonable fees as related to the medi- care standards of hospice reimbursement as es- tablished pursuant to Public Law 99-272, section 9505, effective April 7, 1986, shall be paid for hos- pice services. The effective date of this regulation s…

Scope of rehabilitation ser- vices. Rehabilitation services shall be covered for medicaid recipients when provided by providers enrolled pursuant to K.A.R. 30-5-59. These ser- vices may include the following: (a) Substance abuse treatment provided by an enrolled alcohol and drug …

Reimbursement for rehabil- itation services. (a) Reimbursement for sub- stance abuse treatment and long-term head injury rehabilitation shall be based upon a negotiated rate pursuant to a contract between the Kansas department of social and rehabilitation services and a provider.…

Scope of maternity center ser- vices. Maternity center services shall be covered when provided by a maternity center licensed by the Kansas department of health and environ- ment or its equivalent when provided by a ma- ternity center located out of state. Labor and de- livery sh…

Reimbursement for materni- ty center services. Reasonable fees as related to customary charges shall be paid for maternity cen- ter services, except no fee shall be paid in excess of the range maximum. The range of charges shall provide the base for computations. The effective da…

(Authorized by and implementing K.S.A. 1997 Supp. 39-708c; effective, T-30-10-1- 90, Oct. 1, 1990; effective Jan. 30, 1991; amended Jan. 1, 1999; revoked June 2, 2006.)

(Authorized by and implement- ing K.S.A. 1997 Supp. 39-708c; effective, T-30-10- 1-90, Oct. 1, 1990; effective Jan. 30, 1991; amend- ed July 1, 1994; amended July 1, 1997; amended Jan. 1, 1999; revoked March 19, 2010.)

(Authorized by and implement- ing K.S.A. 1997 Supp. 39-708c; effective Jan. 1, 1999; revoked June 2, 2006.)

(Authorized by K.S.A. 1975 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968; amended Jan. 1, 1971; amended Jan. 1, 1973; amended Jan. 1, 1974; amended, E-76-10, Jan. 23, 1975; amended May 1, 1975; revoked May 1, 1976.)

(Authorized by K.S.A. 1975 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1968;amendedJan.1,1969;revokedMay1,1976.)

(Authorized by K.S.A. 1975 Supp. 39-708c; effective Jan. 1, 1967; amended Jan. 1, 1974; revoked May 1, 1976.)

Co-payment requirements for medikan program recipients. Medikan pro- gram recipients shall be obligated to the provid- er for co-payment amounts identical to the co- payment amounts for medicaid program recip- ients pursuant to K.A.R. 30-5-71. (Authorized by and implementing K.S.…

Scope of hospital services for medikan program recipients. Hospital services for medikan program recipients shall be limited to services provided for the following conditions: 70 DEPARTMENT FOR CHILDREN AND FAMILIES 30-5-152 (a) Acute psychotic episodes; (b) traumatic injury; (c)…

Scope of rural health clinic services for medikan program recipients. The scope of rural health clinic services for me- dikan program recipients shall be identical to the rural health clinic services pursuant to K.A.R. 30- 5-82 covered for adult medicaid program recip- ients. (Au…

Scope of physical therapist services. (a) Physical therapist services shall be covered for medicaid/medikan beneficiaries when provided by a physical therapist who: (1) is certified by medicare; and (2) meets requirements listed in K.A.R. 100-35- 1 through K.A.R. 100-35-7. (b) Th…

Reimbursement for physical therapist services. (a) Reasonable fees for cus- tomary charges shall be paid for physical therapist services except that no fee shall be paid in excess of the range maximum. (b) The range of charges shall provide the base for the computation. (c) The e…

Scope of services by commu- nity mental health centers for medikan pro- gram recipients.Thescopeofcommunitymental health center services for medikan program recip- ients shall be identical to the community mental health center services pursuant to K.A.R. 30-5-86 covered for adult…

Scope of Kan Be Healthy pro- gram services for medikan program recipi- ents. Kan Be Healthy program services shall not be covered for medikan program recipients. (Au- thorized by and implementing K.S.A. 39-708c; effective, T-84-8, April 1, 1983; effective May 1, 1984; amended Jan…