MedicaidReimbursementMedium impact
Increased Rate for Nursing Services for Home Health Pediatric Complex - High Tech Level of Care pdf
Connecticut Medicaid (HUSKY Health)·CT · Pediatrics·Reimbursement
Effective date
Jul 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut's HUSKY Health (Medicaid) increased reimbursement rates by 1.7% for pediatric complex/high-tech nursing services provided by home health agencies, effective retroactively to July 1, 2021. The rate increases apply to specific HCPCS codes S9123 and S9124 with required TG modifiers when providing more than 2 hours of complex nursing care per day to pediatric patients ages 0-18.
Action Required
Immediately: Home health agencies should verify their billing systems reflect the updated rates for HCPCS codes S9123 and S9124 with TG modifiers for pediatric complex nursing services. Continue billing usual and customary charges as Gainwell Technologies will automatically reprocess previously paid claims with retroactive adjustments. Ensure proper use of TG modifier for complex care over 2 hours daily, TT modifier for multiple patients in same residence, and TE modifier for LPN services.