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2024.66 - Provider Bulletin - Diagnosis Requirement for GLP-1 Agonist Medications - Updated 01.15.2025
Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine·Provider Bulletin
Effective date
Jan 15, 2025
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid now requires valid Type 2 diabetes ICD-10 diagnosis codes for all GLP-1 agonist medications (Ozempic, Mounjaro, Trulicity, etc.). Members previously prescribed these medications for non-diabetes conditions have until June 14, 2025 to transition to appropriate therapy or provide approved diagnosis codes.
Action Required
By January 15, 2025: Providers must ensure all GLP-1 agonist prescriptions (Ozempic, Mounjaro, Trulicity, Byetta, Bydureon, Rybelsus, Victoza/liraglutide) include valid Type 2 diabetes ICD-10 diagnosis codes in field 424-DO on NCPDP D.0 pharmacy claims for Connecticut Medicaid patients. Review current patients on these medications for non-diabetes indications and transition to appropriate alternative therapies before June 14, 2025. Claims without approved diabetes diagnosis codes will be denied after the transition period.