MedicaidPrior AuthMedium impact
DSS Important Message - Case Management PA Update pdf
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry·Provider Bulletin
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
For HUSKY Health Medicaid plans, behavioral health case management services (T1016) are now restricted to patients under age 19, and prior authorization is required if more than 96 units (24 hours) are provided within 365 days, effective January 1, 2023. Claims exceeding this limit without PA will be denied with EOB code 6252.
Action Required
Immediately: Billing team must update system to restrict T1016 billing to patients under age 19 for HUSKY Health plans. Add alerts when T1016 units approach 96 within 365 days to prompt prior authorization request from Beacon Health Options before exceeding limit. Claims without PA above 96 units will deny with EOB 6252.