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MedicaidReimbursementMedium impact

2025.35 - Provider Bulletin - Reimbursement Rates for SUD Treatment at Free-Standing Residential Treatment Facilities

Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Reimbursement
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY Health) has updated reimbursement rates for substance use disorder (SUD) residential treatment facilities effective July 1, 2025. New rates are established for different ASAM levels of care, with separate rates based on facility bed count and different billing codes for adult versus adolescent treatment.

Action Required

Action needed
Immediately: SUD residential treatment facilities must update billing systems with new reimbursement rates for HCPCS codes H2034, H2036, and H0047 based on ASAM level of care and facility bed count. Update fee schedules from www.ctdssmap.com. Add modifier HZ for Department of Correction referrals and modifier H9 for Judicial Branch referrals. Ensure SUD diagnosis is listed as primary diagnosis on all claims.

Affected Billing Codes

H2034
H2036
H0047