MedicaidReimbursementHigh impact
DSS Important Message - Frequently Asked Questions - Connecticut Maternity Bundle Billing & Claims 02.11.2025
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut has implemented a new Maternity Bundle Payment Program for HUSKY Health (Medicaid) effective January 1, 2025, transitioning from fee-for-service to bundled payments for maternity care. Providers performing 30+ annual deliveries are automatically enrolled and will receive monthly case rate payments for services during the maternity episode (280 days prior to delivery through 90 days post-delivery), with covered services showing $0 payment and EOB code 9950.
Action Required
Immediately: Billing team must understand that for Connecticut Medicaid maternity patients, claims with trigger diagnosis codes and E&M codes 99202-99205, 99212-99215 will show $0 payment with EOB code 9950 indicating coverage by monthly case rate payment. Update billing system to expect CARC code 245 and RARC M15 for these zero-paid claims. Contact CHNCT, Inc. PES representative for case rate amount questions. Monitor for monthly case rate payments appearing in first payment cycle of following month on remittance advice.