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2025.84 - Policy Updates and Changes to Clinical Review Criteria

Connecticut Medicaid (HUSKY Health)·CT · Physical Therapy, Occupational Therapy, Hematology +7 more·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (CMAP) is implementing extensive policy changes with new coverage policies for habilitative therapy services and gene therapies effective January 1, 2026, plus 25+ new and updated policies for various medical services, devices, and treatments effective February 1, 2026. Several policies are also being retired including External Lower Extremity Nerve Stimulator and Synagis.

Action Required

Action needed
By December 31, 2025: Billing team must review all new and updated policies at https://portal.ct.gov/husky under Information for Providers > Policies, Procedures and Guidelines. Update prior authorization workflows for habilitative therapy services and gene therapies effective January 1, 2026. Prepare for additional policy changes effective February 1, 2026 affecting 25+ services including genetic testing, various medical devices, and therapeutic treatments. Contact CHNCT at 1-800-440-5071 for prior authorization process questions.