Back to dashboard
MedicaidCoverageMedium impact

2024.52 - Provider Bulletin - Updated COVID-19 Vaccine Admin & Pharmacy Coverage for at home COVID Test kits

Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, General Practice +1 more·Pharmacy
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (CMAP) has updated COVID-19 vaccine administration coverage and reimbursement effective October 1, 2024. Key changes include ending vaccine coverage for TB and FAMPL programs, reverting pharmacy reimbursement to AWP plus $1.00, and continuing at-home COVID test kit coverage at current OTC rates.

Action Required

Action needed
Immediately: Update billing system to stop billing COVID-19 vaccine administration for TB and FAMPL program members effective October 1, 2024. Verify pharmacy COVID vaccine reimbursement is set to AWP plus $1.00 methodology. Continue billing CPT 90480 for COVID vaccine administration at 100% Medicare rate for HUSKY Health A, B, C, and D members. Confirm at-home COVID test kits continue at current OTC AWP rates.

Affected Billing Codes

90480