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2021.37 Provider Bulletin - Changes to Medical Surgical Supplies, DME & Orthotics - Prosthetics – Revised 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 is implementing new quantity limits for medical surgical supplies, DME, and orthotic/prosthetic devices effective July 1, 2021. Monthly quantity limits are being reduced for most procedure codes, with prior authorization required for quantities exceeding the new limits.

Action Required

Action needed
By July 1, 2021: Billing team must update billing system with new monthly quantity limits for all affected MEDS procedure codes. Download updated fee schedules from www.ctdssmap.com and reference Table 19 for complete quantity limitations. For quantities exceeding limits, obtain prior authorization with medical necessity documentation before billing. Claims exceeding quantity limits without PA will be denied.

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