All PlansPrior AuthHigh impact
Prior Authorization Requirements for Assistant Surgeons Reminder
Connecticut Medicaid (HUSKY Health)·Orthopedics, General Surgery, Cardiothoracic Surgery +8 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Assistant surgeons must now obtain separate prior authorization for surgical procedures, even when the primary surgeon already has authorization. The primary surgeon's prior authorization does not cover or extend to the assistant surgeon's claim for the same procedure codes.
Action Required
Immediately: Billing team must update workflows to ensure assistant surgeons obtain separate prior authorization for all surgical procedures requiring prior auth (as indicated in Column H of the Physician-Surgical fee schedule). Update billing system to flag assistant surgeon claims that need separate authorization. Train staff that primary surgeon authorization does not cover assistant surgeon services. Contact CHNCT at 1-800-440-5071 for authorization questions. Failure to obtain separate authorization will result in assistant surgeon claim denials.