MedicaidPrior AuthMedium impact
2024.42 - Provider Bulletin - Removal of PA from Wheelchair Repair Procedure Codes - Pricing for Repair Codes
Connecticut Medicaid (HUSKY Health)·CT · PM&R (Physical Medicine & Rehab), Orthopedics·Provider Bulletin
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Effective July 1, 2024, Connecticut Medicaid removed prior authorization requirements for wheelchair repair procedure codes billed with RB modifier. Claims over $1000 or marked as manually priced (MP) will suspend for manual pricing and require invoice documentation within 10 business days.
Action Required
By July 1, 2024: Billing team must update Connecticut Medicaid wheelchair repair claims process to remove prior authorization step for codes with RB modifier. For claims over $1000 or MP codes, prepare to submit pricing documentation (invoice, member ID, date of service, ICN, provider NPI) within 10 business days via fax (860-986-7995), email (ctxix-claimattachments@gainwelltechnologies.com), or mail. Maintain invoices no older than 12 months and keep copies on file to avoid recoupment during post-payment reviews.