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2024.21 - Provider Bulletin Updates to the Person Centered Medical Home Program PDF

Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, Pediatrics +1 more·Provider Bulletin
Effective date
Apr 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut's Person-Centered Medical Home (PCMH) program is removing add-on payments for 34 procedure codes (mostly nursing facility and home visit codes) effective March 31, 2024, while adding telephone consultation codes 99442-99443 and new dental assessment codes with modifier DA for children under 7.

Action Required

Action needed
By April 1, 2024: Billing team must update PCMH program billing rules to remove add-on payments for 34 discontinued codes (99201, 99304-99310, 99315-99316, 99318, 99324-99328, 99334-99337, 99339, 99341-99345, 99347-99350, 99374, 99377, 99379, 99420, D0145, D1206). Add new telephone consultation codes 99442-99443 for PCMH add-on eligibility. For depression screenings, use G8431 for positive results and G8510 for negative results. For dental assessments in children under 7, add modifier DA to E/M codes 99202-99205, 99211-99215, and preventive codes 99381-99383, 99391-99393.

Affected Billing Codes

99201
99304
99305
99306
99307
99308
99309
99310
99315
99316
99318
99324
99325
99326
99327
99328
99334
99335
99336
99337
99339
99341
99342
99343
99344
99345
99347
99348
99349
99350
99374
99377
99379
99420
99442
99443
G8431
G8510
96127
99202
99203
99204
99205
99211
99212
99213
99214
99215
99381
99382
99383
99391
99392
99393
D0145
D1206