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2024.66 - Provider Bulletin - Diagnosis Requirement for GLP-1 Agonist Medications - Updated
Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine·Provider Bulletin
Effective date
Dec 15, 2024
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 (Trulicity, Ozempic, Mounjaro, etc.). Existing patients using these medications for non-diabetes conditions have until June 14, 2025 to transition to other therapies before claims are denied.
Action Required
By January 15, 2025: Providers must ensure all new GLP-1 agonist prescriptions (Trulicity, Byetta, Bydureon, Rybelsus, Victoza/liraglutide, Ozempic, Mounjaro) include valid Type 2 diabetes ICD-10 diagnosis codes. By June 14, 2025: Transition existing patients using GLP-1 medications for non-diabetes conditions to alternative therapies or ensure they have appropriate Type 2 diabetes diagnoses. Update prescription protocols to include required diagnosis codes for pharmacy claims. Failure to comply will result in prescription denials at the pharmacy level.