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2023.44 - Performing Providers Required for Behavioral Health Clinic Providers - Updated 07.31.2023 pdf
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Effective October 1, 2023, all behavioral health clinic providers serving HUSKY Health members must be enrolled in Connecticut Medical Assistance Program (CMAP) and associated with their clinic. Claims without valid performing provider NPIs will be denied with specific EOB codes.
Action Required
By October 1, 2023: Behavioral health clinics must ensure all performing providers are (1) enrolled in CMAP via www.ctdssmap.com Provider Enrollment Wizard and (2) associated with the clinic organization. Organization administrators must use 'Maintain Organization Members' panel to review and associate providers. Update claim submission processes to include valid performing provider NPIs in 837P Loop ID 2420, NPI Segment ID NM109, Qualifier 82. Claims missing valid NPIs will be denied with EOB codes 0231, 1007, 1008, 1010, or 1011.