Credentialing in Kansas

Behavioral health is fully carved IN since 2013: "All pre-2013 Medicaid services are now provided through the KanCare health plans. These include physical health services… behavioral health services, dental and vision care, pharmacy, transportation, and nursing facility care."

KanCare. What is KanCare? · checked Jul 2026

"KanCare is the program through which the State of Kansas administers Medicaid," launched in January 2013; Kansas has contracted with three health plans (managed care organizations) to coordinate health care for all people enrolled in Medicaid, a whole-person, all-populations model.

KanCare. What is KanCare? · checked Jul 2026

Kansas administers Medicaid through KanCare, with KDHE providing financial and contract oversight and KDADS administering waivers, mental health and substance abuse services, and state hospitals.

KanCare. What is KanCare? · checked Jul 2026

The KMAP Mental Health manual § 8200 defines LMHP in two tiers, independent (licensed psychologist, LCMFT, LCPC, LSCSW, licensed clinical psychotherapist) and "LMHP providers licensed to practice under supervision or direction: Licensed Masters level marriage and family therapist, Licensed Masters level professional counselor, Licensed Masters level social worker, Licensed Masters level psychologist", and § 8400 covers psychotherapy "when provided by a Kansas LMHP as defined previously in Section 8200." But "Therapy provided by a nonlicensed person is also not covered" and "Reimbursement will not be allowed for LMHPs to supervise a nonlicensed person who is doing therapy"; supervision "must be provided by a person eligible to provide Medicaid services and licensed at the clinical level or by a licensed physician."

KMAP Mental Health Fee-for-Service Provider Manual (via Wayback capture) · checked Jul 2026

Kansas is on the Counseling Compact jurisdictions list but was NOT issuing compact privileges as of July 2026.

Counseling Compact, Compact Jurisdictions · checked Jul 2026

In Kansas the plain LPC is the pre-clinical, supervised tier; the LCPC is the independent clinical license, requiring "Licensed as an LPC, or meet same qualifications" plus "3000 hours of supervised clinical experience under an approved clinical training plan" and a clinical exam. One umbrella regulator, the Kansas Behavioral Sciences Regulatory Board (BSRB), licenses professional counselors, social workers, MFTs, master's-level psychologists, addiction counselors, psychologists, and behavior analysts.

Kansas Behavioral Sciences Regulatory Board, Professional Counselors · checked Jul 2026

KMAP enrollment is mandatory even for MCO-focused practices: "As of July 1, 2019, the KanCare MCOs started denying payments for providers who are not actively enrolled with KMAP." A lapsed KMAP enrollment silently stops payments from all three MCOs.

KanCare, Become a Provider · checked Jul 2026

On claims, the NPI, provider name, provider type/specialty, taxonomy, and Tax ID "must match exactly as they were submitted at the time of enrollment", mismatches misfire claims across KMAP and all MCOs. The same bulletin restates the 42 CFR 438.602(b)(1) screening mandate behind the consolidated Provider Enrollment Wizard.

KMAP General Bulletin 19115, Managed Care Rule Provider Enrollment · checked Jul 2026

For CPST (H0036-HA/HB, effective for dates of service on or after 2024-07-01) delivered by supervised non-licensed staff, "Each supervising licensed professional/enrolled entity should bill for the services provided as the rendering provider." The bulletin's PT 11 Mental Health Provider specialty list includes 108 LMLP, 109 LCP, 111 CMHC, 112 Psychologist, 115 LMHP, 116 LCMHP, and 121 CCBHC, masters-tier licensees hold their own enrolled KMAP specialties.

KMAP Bulletin 24159 (Sunflower Health Plan newsroom mirror) · checked Jul 2026

The in-network KanCare payment floor is 100% of the fee-for-service rate; out-of-network providers are paid 90%.

KanCare, Become a Provider · checked Jul 2026

"There will be a change in KanCare plans on January 1, 2025… Aetna Better Health of Kansas is being replaced with Healthy Blue." The current MCO lineup is Healthy Blue (Elevance/BCBSKS), Sunflower Health Plan (Centene), and UnitedHealthcare Community Plan, anything still pointed at Aetna Better Health of Kansas after 2025-01-01 is dead.

KanCare Plan Change member letter · checked Jul 2026

"KMAP has 5 days to process and route application to MCOs," and "MCOs have 60 days to credential provider and an additional 30 days after contracting to load provider." Gainwell is the KMAP fiscal agent. (Guidance is KanCare-2.0-era, April 2021. Its Aetna column is now superseded by Healthy Blue.)

KMAP Bulletin 21062, KanCare CMHC Enrollment Guidance · checked Jul 2026

"All providers wishing to enroll with an MCO must now access the application through the Provider Enrollment Wizard. This is the same application used to apply directly with Kansas Medicaid." Providers select the MCOs they want to be credentialed/contracted with as they complete the application. "Only one application is needed, the information will be shared with the MCOs chosen."

KanCare, Become a Provider · checked Jul 2026