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Hospital Monthly Important Message - 02.08.2021 pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) updated billing procedures for 2021 including new HCPCS codes, revised laboratory testing rates, updated COVID-19 vaccine administration billing, and increased outlier threshold to $5,300. Several diagnostic codes were corrected to no longer require Present on Admission indicators.
Action Required
Immediately: Update billing system with new laboratory rates for CPT codes 81316, 81542, 81552, 81554, 85400, 89329, and Q0113 effective retroactive to January 1, 2021. For COVID-19 vaccine administration, ensure claims include both administration codes (0001A, 0002A, 0011A, 0012A) with Revenue Center Code 770 AND vaccine product codes (91300 or 91301) with NDC numbers. Update outlier threshold to $5,300. Resubmit any inpatient claims that denied for POA indicator with diagnosis codes Z11.52 and Z86.16.