MedicaidReimbursementMedium impact
2024.77 - Provider Bulletin - Out-of-State and Border Hospital Reimbursement - Effective 01.01.2025
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has updated reimbursement rates for out-of-state and border hospitals effective January 1, 2025. The policy establishes new APR-DRG base rates, per diem rates for behavioral health and rehabilitation, and updated APC conversion factors for outpatient services.
Action Required
By January 1, 2025: Billing teams at out-of-state and border hospitals serving Connecticut Medicaid patients must update their billing systems with new reimbursement rates: APR-DRG base rate $7,505.68, Behavioral Health per diem $1,050.00, Rehabilitation per diem $1,370.00, and APC conversion factor $71.76. Review Provider Bulletin 2024-76 for updated adjustment factors and DRG weights. Ensure professional practitioners rendering hospital services are enrolled in appropriate professional billing groups.