MedicaidReimbursementHigh impact
DSS Important Message - Frequently Asked Questions - Connecticut Maternity Bundle Billing and Claims
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut is implementing a new Maternity Bundle Payment Program for HUSKY Health (Medicaid) starting January 1, 2025, transitioning from fee-for-service to bundled payments for maternity care. Eligible providers performing 30+ annual deliveries will automatically receive monthly case rate payments for most professional services during the maternity episode, with specific trigger codes and billing requirements.
Action Required
By January 1, 2025: Billing team must update systems to recognize that claims with trigger diagnosis codes plus E&M codes 99202-99205 or 99212-99215 will zero pay and generate monthly case rate payments instead. Update staff training to expect EOB code 9950 'Service is covered by monthly maternity bundle case rate payment' and CARC code 245 with RARC M15 on remittance advices. Contact CHNCT Inc. PES representative for provider-specific case rate amounts. Eligible providers (30+ annual Medicaid deliveries) cannot opt out of this mandatory program.