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MedicaidReimbursementMedium impact

4th Quarter 2021 HIPAA Update - Changes to DME Fee Schedule pdf

Connecticut Medicaid (HUSKY Health)·CT · PM&R (Physical Medicine & Rehab), Wound Care·Reimbursement
Effective date
Nov 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid has added four new HCPCS codes to the DME fee schedule (A4453, K1021, K1022, S9432) with manual pricing, and permanently established an $8.00 maximum fee for non-sterile gloves (A4927) with coverage limited to 3 boxes per month without prior authorization.

Action Required

Action needed
Billing team must update DME fee schedules to include new codes A4453, K1021, K1022, and S9432 with manual pricing (lesser of MSRP minus 15% or Actual Acquisition Cost plus 35%). Set maximum fee of $8.00 for A4927 non-sterile gloves with 3 boxes per month limit before prior authorization is required.

Affected Billing Codes

A4453
K1021
K1022
S9432
A4927