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
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
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.