MedicaidPrior AuthMedium impact
2023.67 Provider Bulletin - Prior Authorization Threshold for Procedure Code B9998 – NOC Enteral Supplies pdf
Connecticut Medicaid (HUSKY Health)·CT · Gastroenterology, General Surgery, Pediatrics·Prior Authorization
Effective date
Nov 1, 2023
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid increased the prior authorization threshold for procedure code B9998 (NOC Enteral Supplies) from $150 to $279, effective November 1, 2023. Claims exceeding $279 will now require prior authorization or they will be denied.
Action Required
Immediately: Billing team must update prior authorization triggers for HCPCS code B9998 in billing system - change threshold from $150 to $279 for Connecticut Medicaid claims. Update encounter forms and staff training materials to reflect new $279 threshold. Ensure prior authorization is obtained before billing amounts exceeding $279 or claims will be denied.