MedicaidAdministrativeMedium impact
Outpatient Crossover Claim Pricing Changes pdf
Connecticut Medicaid (HUSKY Health)·CT·Coding
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has changed how outpatient crossover claims are priced effective January 1, 2022. Claims with Medicare information will now be priced using detail-level data instead of header-level data, and providers can now submit copay information using claim adjustment reason code 3.
Action Required
Future requirement (timeline TBD): Billing team must update claim submission systems to include Medicare information at the detail level using ASC X12N 837I format per Chapter 11 of Provider Manual. Monitor for additional notifications with specific implementation dates. Failure to submit detail-level Medicare information will result in claim denials once fully implemented.