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MedicaidReimbursementMedium impact

2025.82 - Updating Physician Administered Drugs on Select Fee Schedules

Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, General Practice +3 more·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid will update reimbursement rates for physician-administered drugs, immune globulins, vaccines, and toxoids to 100% of the January 2026 Medicare Average Sales Price (ASP) Drug Pricing file. This affects behavioral health, dialysis, family planning, medical clinics, and substance use disorder treatment facilities.

Action Required

Action needed
By January 1, 2026: Billing team must download updated fee schedules from www.ctdssmap.com under Provider > Provider Fee Schedule Download. Review new reimbursement rates for physician-administered drugs, vaccines, and immune globulins. Update billing system with new rates based on January 2026 Medicare ASP pricing. Continue following PB 2018-10 guidelines for billing physician-administered drugs.