Some Kansas pediatricians are considering cutting the number of Medicaid patients they see because of a billing change that reworks how a checkup is coded and reimbursed, according to The Kansas City Star.
The change, which took effect Nov. 1, requires pediatricians to submit 12 separate codes for checkup services that used to be bundled under one code. Since some of the 12 services aren't always performed for children in certain age groups, pediatricians are being reimbursed less for patients with coverage under Medicaid or the Children's Health Insurance Program.
One pediatrician told Melissa Hudelson, the executive director of American Academy of Pediatrics' Kansas chapter, that she is now reimbursed $26 for checkups for 1-month-olds, down from $70.
Kansas' Medicaid Director, Jon Hamdorf, told The Kansas City Star the bundled services were separated so the state could track which patients were receiving which services. The change allows providers like county health departments to bill for a single service if that's all they provide.
Roughly 40 percent of children in Kansas are covered by Medicaid or CHIP. While Ms. Hudelson said most providers can't stop accepting Medicaid or CHIP completely, some are considering limiting the number of Medicaid patients they treat, according to the report.