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MedicaidReimbursementMedium impact

2025.70 - January 2026 Quarterly HIPAA Updates-Physician-Office and Outpatient, and Physician Surgery Fee Schedules - Physician Administered Drug Reimbursement Updates

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

Summary

Connecticut Medicaid (HUSKY Health) is implementing January 2026 HCPCS code updates to maintain HIPAA compliance and updating physician-administered drug reimbursement rates to 100% of Medicare's January 2026 Average Sales Price. Updated fee schedules will be available on the CMAP website.

Action Required

Action needed
By January 1, 2026: Billing team must download updated fee schedules from www.ctdssmap.com (Provider > Provider Fee Schedule Download) to access new HCPCS codes and physician-administered drug rates for HUSKY Health programs. Verify billing system reflects updated drug reimbursement rates at 100% of Medicare ASP. Contact Provider Assistance Center at 1-800-842-8440 for technical assistance accessing schedules.