MedicaidBilling CodesMedium impact
Billing Guidance for Chimeric Antigen Receptor Cell Treatments pdf
Connecticut Medicaid (HUSKY Health)·CT · Oncology, Hematology·Provider Bulletin
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has clarified billing procedures for CAR-T cell treatments, requiring hospitals to bill the biologic procedure codes (Q2041, Q2042, Q2053, C9076) on separate outpatient claims with revenue code 0891 at the time of cell harvesting, not on the inpatient claim when cells are administered. Prior authorization requirements remain unchanged but require separate PAs for both the CAR-T treatment and inpatient admission.
Action Required
Immediately: Billing team must update CAR-T cell treatment billing workflow to submit biologic procedure codes (Q2041, Q2042, Q2053, C9076) on separate outpatient claims with revenue code 0891 at time of cell harvesting, not on inpatient claims. Ensure staff understand that two separate prior authorizations are required - one for CAR-T treatment and one for inpatient admission. Update billing system rules to prevent biologic codes from being included on inpatient CAR-T claims.