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Hospital Monthly Important Message - 04.13.2021 pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Apr 20, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) is reinstating prior authorization requirements for inpatient admissions, outpatient behavioral health, and advanced radiology services effective April 20, 2021. Multiple billing issues have been resolved including suspended DRG claims and missing POA indicators. COVID-19 vaccine administration reimbursement increased to $40 with new Janssen vaccine coding added.
Action Required
By April 20, 2021: Hospital billing teams must reinstate prior authorization processes for inpatient admissions, outpatient behavioral health services, and advanced radiology/imaging services for Connecticut Medicaid patients. Update billing system to require PA verification before scheduling these services. For COVID-19 vaccines, use updated administration codes (0001A, 0002A, 0011A, 0012A, 0031A) with $40 reimbursement rate and include vaccine product codes (91300, 91301, 91303) with NDC numbers. Claims without proper PA will be denied after April 20.