MedicaidPrior AuthHigh impact
DSS Important Message - Hospital Monthly Important Message - 01.17.2025
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) has updated CMAP Addendum B with 2025 HCPCS code changes, implemented new APR-DRG weights, and requires prior authorization for 9 specific J-codes for outpatient hospital services effective November 15, 2024.
Action Required
Immediately: Billing team must verify prior authorization is obtained for J-codes J0172, J0174, J0224, J1413, J1426, J1427, J1429, J3241, and J7330 for all Connecticut Medicaid outpatient hospital claims with dates of service November 15, 2024 and forward. Update billing system edits to flag these codes. Download updated CMAP Addendum B V26.0 from www.ctdssmap.com when available. Claims without prior authorization for these codes will be denied.