MedicaidReimbursementHigh impact
2024.44 - Provider Bulletin - Maternity Bundle Payment Program
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN·Reimbursement
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) is implementing a new Maternity Bundle Payment Program starting January 1, 2025, transitioning from fee-for-service to episode-based payments for maternity care. Eligible providers (30+ deliveries annually) will receive monthly case rate payments starting in the second trimester and potential incentive payments based on cost and quality performance.
Action Required
By January 1, 2025: Billing team must update billing practices for Connecticut Medicaid maternity patients. Stop using global maternity codes and instead bill specific E&M codes (99202-99205, 99212-99215) with trigger diagnosis codes to initiate case rate payments. Update billing software to identify services covered by monthly case rate payments (will show EOB code 9950). Ensure billing uses qualifying place of service codes (11, 19, or 22) and appropriate specialty codes (328, 095, 091, or 122). Case rate payments will appear on remittance advice as lump sum payments with MB prefix. Providers performing consultative services should avoid trigger codes to prevent unintentional episode attribution.