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January 2023 HIPAA Update for DME & and MSS Fee Schedule pdf

Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Family Medicine, Internal Medicine·Reimbursement
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid updated DME and CGM billing codes for HIPAA compliance effective January 1, 2023. Key changes include replacing codes K0553/K0554 with A4239/E2103 for non-adjunctive CGMs, and discontinuing codes A9276, A9277, A9278 as non-payable.

Action Required

Action needed
Immediately: Billing team must update system to use new codes A4239/E2103 instead of discontinued codes K0553/K0554 for non-adjunctive CGMs. Stop billing codes A9276, A9277, A9278 as they are no longer payable. Ensure prior authorization is obtained for all CGM systems. Do not bill codes A4233-A4259, E0607, E2101 separately when A4239 is billed within 30 days for same patient. Update fee schedule from www.ctdssmap.com.

Affected Billing Codes

A4238
E2102
A9276
A9277
A9278
A4239
E2103
K0553
K0554
A4233
A4259
E0607
E2101
January 2023 HIPAA Update for DME & and MSS Fee Schedule pdf | Connecticut Medicaid (HUSKY Health) | PolicyChanges.app