MedicaidCoverageMedium impact
Req for Coverage of OTC Nutritional Supplements pdf
Connecticut Medicaid (HUSKY Health)·CT · Pediatrics, Family Medicine·Provider Bulletin
Effective date
Dec 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid will become the primary payor for special/prescription infant formulas and medical foods for patients enrolled in both WIC and Medicaid programs, effective December 1, 2021. Standard infant formulas will continue to be covered by WIC, but special formulas will now be billed to Medicaid with required diagnosis codes.
Action Required
Effective December 1, 2021: For Connecticut patients dually enrolled in WIC and Medicaid requiring special infant formulas or medical foods, billing team must bill Medicaid as primary payor instead of WIC. Ensure valid diagnosis codes are included for all nutritional supplement claims. Reference Section 8.5 of the Pharmacy Provider Manual at www.ctdssmap.com for acceptable diagnosis codes specific to under 21 and over 21 populations.