MedicaidReimbursementMedium impact
2025.78 - Provider Bulletin - REVISED Out-of-State and Border Hospital Reimbursement-Effective 01.01.2026
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has updated reimbursement rates for out-of-state and border hospitals effective January 1, 2026. The APR-DRG base rate increased to $7,505.68, behavioral health per diem to $1,050.00, rehabilitation per diem to $1,370.00, and APC conversion factor to $71.76.
Action Required
Before January 1, 2026: Billing team must update reimbursement rate tables in billing system for Connecticut Medicaid claims from out-of-state hospitals. Update APR-DRG base rate to $7,505.68, behavioral health per diem to $1,050.00, rehabilitation per diem to $1,370.00, and APC conversion factor to $71.76. Review Provider Bulletin 2025-77 for updated adjustment factors and APR-DRG weights.