MedicaidPrior AuthMedium impact
Hospital Monthly Important Message - 11.19.2024
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Nov 15, 2024
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) now requires prior authorization for 9 specific drug injection codes (J-codes) for outpatient hospital services effective November 15, 2024. Claims for these high-cost specialty medications will be denied without proper prior authorization.
Action Required
Immediately: Billing team must update system to require prior authorization for J-codes J0172, J0174, J0224, J1413, J1426, J1427, J1429, J3241, and J7330 for outpatient hospital services. Contact CHNCT at 1-800-440-5071 for prior auth process. Access authorization portal at https://portal.ct.gov/HUSKY. Claims submitted without prior auth will be denied.