DELIVERING CUSTOMIZED THERAPEUTIC SERVICES TO ENHANCE FUNCTIONAL ABILITY, COMMUNICATION, AND QUALITY OF LIFE

Specialized Therapies in Kansas are designed to meet the unique rehabilitative and developmental needs of individuals with disabilities, injuries, or chronic conditions. These services are authorized under Kansas Medicaid (KanCare) through the Medicaid State Plan and various Home and Community-Based Services (HCBS) waiver programs. The goal is to help participants improve or maintain optimal functioning in home and community environments.

1. GOVERNING AGENCIES

Agency: Kansas Department of Health and Environment (KDHE) — Division of Health Care Finance
Role: Oversees Medicaid reimbursement, provider enrollment, and therapy billing codes

Agency: Kansas Department for Aging and Disability Services (KDADS)
Role: Monitors therapy service delivery under HCBS waivers, ensures ISP alignment, and defines therapy standards

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring specialized therapies meet clinical and Medicaid compliance standards

Agency: Managed Care Organizations (MCOs) under KanCare
Role: Authorize services, review progress reports, and reimburse therapy providers

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2. SPECIALIZED THERAPY SERVICE OVERVIEW

Specialized Therapies provide individualized treatment for functional, physical, cognitive, and communication needs. These therapies may be rehabilitative or habilitative, depending on the participant’s condition and plan of care.

Approved providers may deliver:

• Occupational Therapy (OT) — to improve fine motor skills, ADLs, and sensory processing
• Physical Therapy (PT) — to improve gross motor skills, strength, balance, and mobility
• Speech-Language Pathology (SLP) — to address speech, language, swallowing, and communication disorders
• Behavioral Therapy / Cognitive Therapy — to support behavioral regulation and social-emotional skills
• Music or Art Therapy (when authorized under specific programs)
• Augmentative and alternative communication (AAC) evaluation and support
• Feeding therapy or sensory integration (based on therapist evaluation and MCO approval)

All services must be medically necessary, included in the participant’s Plan of Care or ISP, and provided under physician orders when required.

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Kansas Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Ensure all therapists hold Kansas state licenses (OT, PT, SLP, etc.)
• Enroll as a Medicaid therapy provider through the Kansas Medical Assistance Program (KMAP) portal
• Coordinate service authorization and credentialing with KanCare MCOs
• Carry professional liability and general liability insurance
• Develop documentation, treatment planning, progress tracking, and HIPAA-compliant policies

4. KANSAS PROVIDER ENROLLMENT PROCESS

Initial Application:

• Apply via KMAP to become a therapy provider under Kansas Medicaid
• Coordinate with MCOs (Aetna, UnitedHealthcare, Sunflower) for credentialing and contracting

Documentation Submission:

• Provide business incorporation papers, therapist licenses, proof of insurance, policy manual, and staff credentials

Authorization Process:

• Submit physician referrals and therapy evaluation reports to MCOs for prior authorization
• Maintain regular progress notes and submit reauthorization requests as needed

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5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Kansas Secretary of State)
• IRS EIN confirmation
• NPI confirmation
• Proof of professional and general liability insurance
• Current Kansas therapy licenses for each clinician

Specialized Therapy Policy & Procedure Manual including:

• Participant assessment, care plan development, and progress reporting
• Therapy modality procedures and session tracking
• Emergency and incident reporting protocols
• HIPAA compliance, participant rights, and grievance processes
• Staff licensure records, training logs, and supervision policies
• Medicaid billing forms, CPT coding, and audit-ready service documentation

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6. STAFFING REQUIREMENTS

Role: Clinical Therapy Director / Lead Therapist
Requirements: Licensed OT, PT, or SLP in Kansas, supervisory experience, background check clearance

Role: Licensed Therapists (OT, PT, SLP, Behavioral)
Requirements: Current Kansas licensure, Medicaid documentation experience, background screening clearance

Role (optional): Therapy Assistants (COTA, PTA, SLPA)
Requirements: State certification, must work under direct supervision of licensed therapist

All staff must complete:

• HIPAA and confidentiality training
• Participant safety, abuse prevention, and emergency protocols
• Documentation and billing compliance training
• Annual continuing education and licensure renewals

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7. MEDICAID PROGRAMS & HCBS WAIVERS

Specialized Therapies are covered under:

• Kansas Medicaid State Plan (short-term rehabilitative therapies)
• KanCare MCO Plans

HCBS Waivers (as applicable):

• Intellectual/Developmental Disability (IDD) Waiver
• Physical Disability (PD) Waiver
• Autism Waiver
• Brain Injury (BI) Waiver
• Frail Elderly (FE) Waiver
• Technology Assisted (TA) Waiver (for medical therapies)

Authorized services may include:

• Evaluation, planning, and delivery of skilled therapy interventions
• Caregiver training and therapy carryover instruction
• Ongoing assessments and reauthorizations

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8. TIMELINE TO LAUNCH

Phase: Business Formation, Licensing Verification, and Policy Manual Development
Timeline: 1–2 months

Phase: Staff Credentialing and MCO Contracting
Timeline: 2–3 months

Phase: Medicaid Enrollment and Readiness Review
Timeline: 60–90 days

Phase: Billing System Configuration and Service Launch
Timeline: 30–45 days

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9. CONTACT INFORMATION

Kansas Department of Health and Environment (KDHE)
Website: https://www.kdhe.ks.gov

Kansas Department for Aging and Disability Services (KDADS)
Website: https://kdads.ks.gov

Kansas Medical Assistance Program (KMAP)
Website: https://www.kmap-state-ks.us

KanCare MCOs:

• Sunflower Health Plan: https://www.sunflowerhealthplan.com
• UnitedHealthcare Community Plan: https://www.uhccommunityplan.com/ks
• Aetna Better Health of Kansas: https://www.aetnabetterhealth.com/kansas

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10. SCOPE OF WORK 

• Business registration, KMAP enrollment, and KanCare MCO credentialing
• Development of Specialized Therapy Policy & Procedure Manual
• Therapist credentialing templates, service logs, and documentation systems
• Medicaid billing setup and CPT coding audit tools
• Website, domain, and clinical branding
• Quality assurance systems for documentation, service tracking, and clinical outcomes
• Referral development with schools, case managers, and waiver service teams

Waiver Consulting Group supports therapy practices, school-based providers, and HCBS agencies in launching Medicaid-compliant Specialized Therapy Services across Kansas.