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Performing Providers Required for Behavioral Health Clinic Providers pdf

Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY Health) now requires all behavioral health clinic providers to be enrolled in CMAP and have their NPI included on all claims. Claims without valid performing provider NPIs will be denied starting October 1, 2023, with a grace period through September 30, 2023.

Action Required

Action needed
By October 1, 2023: Behavioral health clinics must ensure all performing providers are enrolled in Connecticut Medical Assistance Program (CMAP) using the Gainwell Technologies Provider Enrollment Wizard at www.ctdssmap.com. Update billing system to include performing provider NPI on all claims in 837P segment NM109, Loop ID 2420, Qualifier 82. Associate all providers to clinic organization through 'Maintain Organization Members' panel. Claims without valid performing provider NPIs will be denied with EOB codes 0231, 1007, 1008, 1010, or 1011.