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Bulletin - Changes to Medical Surgical Supplies - DME - Orthotic - Prosthetic Devices pdf

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

Summary

Connecticut Medicaid has reduced monthly quantity limitations for multiple medical/surgical supplies, DME, and orthotic/prosthetic procedure codes, effective retroactively to July 1, 2021. The changes significantly decrease allowed quantities for many codes, such as A4310 dropping from 10 to 6 units per month and T-codes reducing from 250 to 220 units monthly.

Action Required

Action needed
Immediately: Billing team must update Connecticut Medicaid quantity limits in billing system for all affected MEDS codes to reflect new monthly maximums (retroactive to July 1, 2021). Download updated fee schedules from www.ctdssmap.com and replace existing schedules. Review all Connecticut Medicaid claims for these codes since July 1, 2021 to identify potential overpayments that may need to be refunded. Notify providers of new quantity restrictions to prevent future denials.

Affected Billing Codes

A4310
A4311
A4312
A4313
A4314
A4315
A4316
A4320
A4322
A4326
A4338
A4340
A4344
A4354
A4357
A4358
A6023
A7045
A9273
T4521
T4522
T4523
T4524
T4525
T4526
T4527
T4528
T4543
T4544