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MedicaidReimbursementHigh impact

2025.66 - Provider Bulletin - Maternity Bundle Payment Program – Performance Year 2

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Reimbursement
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut's HUSKY Health Maternity Bundle Payment Program enters Performance Year 2 starting January 1, 2026, continuing the episode-based payment model for maternity care. Providers meeting eligibility requirements (30+ deliveries annually) will receive monthly case rate payments for prenatal and postpartum services, with specific billing trigger requirements using designated E&M codes and specialty types.

Action Required

Action needed
Before January 1, 2026: Eligible maternity providers must update billing practices to use specific E&M codes (99202-99205, 99212-99215) with trigger diagnosis codes to initiate case rate payments. Billing team must configure systems to bill with qualifying specialty types (328-OB/GYN, 095-CNM, 091-Obstetric NP, 122-Women's Health NP) and place of service codes (11, 19, 22). Providers using global maternity codes must transition away from global billing as it will not qualify as trigger events. Family medicine providers rendering maternity care who attested in August 2025 should be included in case rate billing.

Affected Billing Codes

99202
99203
99204
99205
99212
99213
99214
99215