Kansas Telehealth Billing and Policy
Kansas telehealth billing and policy covers how telehealth services are defined, delivered, and reimbursed across KanCare Medicaid and private payers. This page outlines the key rules, billing requirements, and considerations for providers delivering care in Kansas.
Rules and Regulations
Understanding Kansas telehealth billing and policy begins with how the state defines telemedicine and sets requirements for care delivery.
Definition and Scope
Under Kansas law, “telemedicine” (often used interchangeably with “telehealth”) is defined as the delivery of healthcare services while the patient is at one physical originating site and the provider is at a different distant site using:
- real-time interactive audio/visual communication, and
- secure video conferencing or store-and-forward technology that supports health care delivery.
Telephone-only, email, or fax communications alone are not considered telemedicine.
Key statutory definitions include:
- Originating site: where the patient is located at the time of service.
- Distant site: where the provider is located.
- Healthcare provider: physicians, physician assistants, advanced practice RNs, and other licensed/certified health professionals.
Consent & Patient-Provider Relationship
Informed Consent
- Providers must obtain patient consent before delivering telehealth services.
- Kansas Medicaid specifically allows verbal consent (documented in the record) followed by written consent in the record.
Patient-Provider Relationship
- Kansas statutes expressly allow telemedicine as a means to establish a valid provider-patient relationship.
- The same standard of practice and conduct applies as with in-person services.
Licensure Requirements
In-State Providers
- Providers must hold a current Kansas license in their profession (e.g., physician license from the Kansas State Board of Healing Arts) to treat Kansas patients via telehealth.
Out-of-State Providers
Kansas has a statutory process permitting out-of-state physicians to practice telemedicine within Kansas if they obtain a specific telemedicine waiver from the Board of Healing Arts, which:
- Requires an application, background information, and a fee (≤ $100).
- Is issued within ~15 business days if requirements are met.
- Must be renewed annually.
- Subjects the physician to the same rules as licensed Kansas practitioners.
Standards of Care & Clinical Practice
Standard of Care
- Telehealth encounters must meet the same clinical standards as in-person care (professional judgment, documentation, quality, safety).
Reporting & Follow-up
- Providers delivering telemedicine must report to the patient’s primary care or other treating physician within 3 business days when:
- the patient consents, and
- the patient has an existing primary care or treating physician.
- Behavioral sciences providers are exempt from this reporting requirement.
Prescribing Via Telehealth
- A DEA federal waiver is allowing prescribing of controlled substances via telehealth without a prior in-person visit or meeting one of the existing statutory exceptions through December 31, 2026.
- The Kansas Board of Healing Arts (in consultation with pharmacy and nursing boards) was directed to adopt rules for prescribing, including controlled substances, via telemedicine.
- A valid provider-patient relationship must be established before prescribing; generally this can be done through an appropriate telehealth encounter.
Prescribing rules, especially for controlled substances, can have additional requirements and limitations — including documentation and possibly in-person evaluation requirements for certain drugs.
Reimbursement
Kansas Medicaid
- Kansas Medicaid covers live video telemedicine if medically necessary, if delivered by an appropriately licensed and enrolled provider, and if compliant with state protocols.
- Written consent and prior authorization may be required for certain home telehealth services.
- For Out-of-State Providers:
- Telemedicine services will be reimbursed at the same rate as services provided face-to-face.
- Providers must use allowable codes as outlined in existing telemedicine policies and ensure all billed services are covered under KMAP.
- Hospital admitting privileges are not required for out-of-state providers delivering telemedicine services only.
- All documentation requirements are the same as for in-person services.
Private Payers
- Kansas has private-payer telehealth insurance laws requiring coverage for telehealth services that are comparable to in-person services under qualifying plans, subject to terms of the health plan. This means that private payers must cover the same services through telehealth as they do for in-person visits. However, private payers are able to set their own rates for reimbursement, which could be higher or lower than that of in-person services.
Privacy & Technology Requirements
- Telehealth technology must be HIPAA compliant to protect patient privacy and PHI.
- Providers should ensure secure communication systems (encrypted video, secure portals).
- Kansas Medicaid specifically requires HIPAA compliance for tele-video communications.
Billing for Telehealth in Kansas
Telehealth is treated as a method of delivery, and Kansas telehealth billing and policy follows standard coding and reimbursement practices.
The Kansas Telemedicine Act
The Kansas Telemedicine Act authorizes an insurance company, nonprofit health service corporation, nonprofit medical and hospital service corporation, or health maintenance organization to establish payment or reimbursement of covered healthcare services delivered through telemedicine in the same manner as payment or reimbursement for covered services delivered via in-person contact.
The bill does not mandate coverage for a healthcare service delivered via telemedicine, if such service is not already a covered service when delivered by a healthcare provider, and subject to the terms and conditions of the covered individual’s health benefits plan.
Before billing for telemedicine, Providers must be enrolled/contracted with KanCare (Medicaid) prior to billing for telehealth services. Services must be delivered within the provider’s scope of practice and meet standard clinical criteria just as they would in an in-person encounter.
Procedure Code
Standard CPT/HCPCS Codes:
Use the same CPT/HCPCS procedure codes you would for in-person services when delivering via telehealth (e.g., E/M, therapy, consultation) — telehealth is treated as a method of delivery, not separate services.
Eligible Services:
Kansas Medicaid covers many services when delivered via telemedicine, such as office visits, individual therapy, pharmacological management, and others listed by KanCare. Providers must check the current KanCare provider manual for the precise list of reimbursable telehealth codes.
Place of Service
The provider at the distant side must bill an appropriate code from the lists below with place of service (02) designating a telemedicine service provided other than in the patient’s home OR place of service (10) designating a telemedicine service provided in the patient’s home. (Please note: the GT modifier is no longer used to designate a telemedicine service.)
As documented in related telemedicine policies, telemedicine claims at the distant site must contain place of service 02 (Telehealth distant site). Providers at the originating site are required to submit claims using code Q3014 (Telehealth originating site facility fee)
Notes
- POS codes like 10 may be used by private payers or Medicare for home telehealth, but for KanCare telemedicine POS 02 remains standard per state guidance.*)
- Some manuals mention POS codes for settings such as home (POS 12) only under specific bulletins — but POS 02 is the consistent KanCare requirement for most telehealth billing.
Distant site means a site at which the healthcare provider is located while providing healthcare services by means of telemedicine.
Originating site means a site at which a patient is located at the time healthcare services are provided by means of telemedicine. Authorized originating sites do not currently include a person’s home.
Modifiers
GT or 95 — Kansas Medicaid generally treats telehealth modifiers like GT or 95 as informational; inclusion is not required and omission usually won’t result in denial. However, commercial payers might require 95 for synchronous telehealth.
Consent and Documentation
Telemedicine services (including telephonic contact) can be made when there is verbal consent received from the patient (to be followed up by written approval) in the medical record. Tele-video communication can only be utilized if that contact is HIPAA compliant. Maintain documentation of the service, patient location, modality used, and clinical necessity — documentation standards are the same as in-person care.
Out-of-State Providers
See General Benefits Provider Manual for information concerning out-of-state providers.
Payor Codes
Note: QMB only codes are not noted in these tables. Additionally, telemedicine rules governing HCBS waiver codes may change depending on waiver submissions; therefore, the specific HCBS waiver manual needs to be consulted for current code status allowances. KMAP does not recognize AMA CPT consultation codes 99242, 99243, 99244, 99245, 99252, 99253, 99254, and 99255 for payment.
Private Payers (Commercial Plans)
- Kansas has private-payer telehealth insurance laws requiring coverage for telehealth services that are comparable to in-person services under qualifying plans, subject to terms of the health plan. This means that private payers must cover the same services through telehealth as they do for in-person visits. However, private payers are able to set their own rates for reimbursement, which could be higher or lower than that of in-person services.
- Documentation: The insured’s medical record should satisfy all documentation requirements for telemedicine reimbursement; no extra documentation beyond typical medical records is required.
- Coverage Limits: Telemedicine coverage may be limited to medically necessary services and subject to the terms and conditions of the covered individual’s health benefits plan.
KanCare (Kansas Medicaid)
- Coverage of Telehealth: KanCare must cover telehealth services (including live video and certain audio-video communications) that are medically necessary and covered when provided in person. Telemedicine services are not excluded solely because they’re provided remotely. Kansas Revisor of Statutes
- Reimbursement Basis: Covered services delivered via telemedicine are reimbursed on the same basis as when delivered in person, subject to the terms of the Medicaid program and coverage rules. Kansas Revisor of Statutes
- Provider Enrollment: Providers must be enrolled with KanCare/Medicaid in order to bill telehealth services. (This is standard Medicaid billing practice — enrollment and credentialing are required before submitting claims.)
Additional Notes
- Private Payer Reimbursement: Payment parity is not guaranteed — insurers can set reimbursement terms as part of their contracts. Kansas Revisor of Statutes
- Medicare: Federal Medicare telehealth rules are separate from state law — consult the latest CMS guidance for Medicare billing.
- Always refer to the KanCare Provider Manuals and specific managed care organization guidelines for the most current telehealth billing rules and allowable codes.
Quick Billing Summary — Kansas Telehealth
Scenario: Telehealth office visit for a KanCare member
Bill the same CPT/HCPCS code used for in-person services
Use POS 02 for telehealth at a distant site (per KanCare policy)
Include telehealth modifiers (95/GT) if required by payer
Add Q3014 for originating site facility fee when patient is at a qualifying site
Submit through the KanCare billing system or managed care plan portal
Checklist for a Kansas Primary Care Clinic
Understanding Kansas telehealth billing and policy helps ensure services are delivered and billed appropriately.
To implement telehealth in Kansas lawfully, your clinic should ensure:
- Licensure Compliance
- All providers are licensed in Kansas or have appropriate telehealth waivers/licensure via compact.
- Telehealth Policy & Consent
- Written telehealth policies, patient consent procedures, and documentation practices are established.
- Clinical Standards
- Telehealth services follow the same standards as in-person care, including reporting and follow-up protocols.
- Technology & Privacy
- Only HIPAA-compliant platforms for video visits. List of Telehealth Platforms
- Billing & Reimbursement
- Proper coding, payer requirements understood (e.g., Medicaid, private insurance). Telehealth Certification Institute KANSAS MEDICAL ASSISTANCE PROGRAM Fee-for-Service Provider Manual
- Prescribing Requirements
- Policies for telemedicine prescribing align with state board rules.
Telehealth billing and policies are essential for providers across Kansas, Missouri, and Oklahoma. To start a telehealth service, you must focus on licensing and regulation, technology, and business operations. The key requirements include ensuring your providers are licensed in your state, using secure technology, and developing a clear plan for billing and patient care. Most telehealth billing and policies are determined state-by-state, so it is important to review both state and federal guidance.
Choose your state-specific guidance below, or scroll down for federal guidance and Medicare policies.
References
- Kansas Department of Health and Environment. General Benefits Provider Manual
- Kansas Telehealth Policies- Center for Connected Health Policy
- Kansas Telemedicine Act- Kansas Health Institute
- Out-of-state physician practice, L. 2021, ch. 88, § 10; May 6. Kansas State Legislature
- Federal licensure and telehealth legal considerations. telehealth.hhs.gov
- Legal Requirements for Using Telehealth. American Academy of Family Physicians
- Kansas Board of Healing Arts.
- Parity laws- Kansas Legislature
