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MedicaidReimbursementMedium impact

Provider Bulletin - January 2021 - Laboratory Fee Schedule pdf

Connecticut Medicaid (HUSKY Health)·CT · Oncology, OB-GYN·Reimbursement
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid updated their laboratory fee schedule effective January 1, 2021, converting manually priced lab codes to fixed rates at 70% of Medicare rates and adding coverage for myChoice CDx ovarian cancer test with prior authorization required.

Action Required

Action needed
Immediately: Billing team must download updated Connecticut Medicaid laboratory fee schedule from www.ctdssmap.com and update billing system with new fixed reimbursement rates for the listed genetic testing codes. For myChoice CDx ovarian cancer testing, submit prior authorization before billing CPT 81599 or claims will deny. Verify current rates are 70% of Medicare for converted codes.

Affected Billing Codes

81163
81164
81165
81166
81167
81171
81172
81173
81174
81177
81178
81179
81180
81181
81182
81183
81184
81185
81186
81187
81188
81189
81190
81204
81233
81234
81236
81237
81239
81271
81274
81284
81285
81286
81289
81305
81306
81312
81320
81599