MedicaidCoverageHigh impact
DSS Important Message - GLP-1 Diagnosis Code Reminder
Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine·Provider Bulletin
Effective date
Dec 15, 2024
We identified it
Jun 20, 2026
Summary
DSS has updated GLP-1 prescription requirements based on when patients started therapy. Patients who received GLP-1s before December 15, 2024 can continue with any valid ICD-10 diagnosis through June 14, 2025, but new patients starting after December 15, 2024 must have a Type 2 diabetes diagnosis code or claims will be denied.
Action Required
Immediately: Billing team must verify patient GLP-1 therapy start dates and ensure proper ICD-10 diagnosis codes are submitted. For patients new to GLP-1 therapy after December 15, 2024, only submit claims with Type 2 diabetes diagnosis codes. For existing patients (pre-December 15), any valid ICD-10 code is acceptable through June 14, 2025. Update billing system to flag GLP-1 claims without diagnosis codes to prevent EOB 3302 denials.