MedicaidAdministrativeHigh impact
Outpatient Crossover Claim Pricing Changes pdf
Connecticut Medicaid (HUSKY Health)·CT·Coding
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid now requires outpatient hospitals to submit Medicare information at the claim detail level for crossover claims, and allows submission of copay information using CARC code 3. This change affects how crossover claims are priced and processed.
Action Required
Immediately: Outpatient hospital billing teams in Connecticut must begin submitting Medicare information at the claim detail level using ASC X12N 837I format. Update billing systems to include copay information using claim adjustment reason code (CARC) 3 in loop 2430 CAS segment. Review Chapter 11 of the Provider Manual at www.ctdssmap.com for required loops and segments. Future mandate will require this information or claims will be denied - begin implementation now to avoid disruptions.