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MedicaidReimbursementMedium impact

Out-of-State and Border Hospital Reimbursement pdf

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

Summary

Connecticut has updated reimbursement rates for out-of-state and border hospitals serving Connecticut Medicaid patients effective January 1, 2023. New inpatient APR-DRG base rate is $7,505.68 and outpatient APC conversion factor is $71.76, with updated per diem rates for behavioral health ($1,050) and rehabilitation ($1,370).

Action Required

Action needed
For out-of-state and border hospitals billing Connecticut Medicaid: Update billing system with new rates effective January 1, 2023 - APR-DRG base rate $7,505.68, behavioral health per diem $1,050, rehabilitation per diem $1,370, and APC conversion factor $71.76. Reference Provider Bulletin 2022-96 for APR-DRG adjustment factors. Ensure professional services are billed through enrolled professional billing groups per existing bulletins.