MedicaidReimbursementMedium impact
OOS and Border Hospital Reimbursement - Effective 01.01.2021 pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated reimbursement rates for out-of-state and border hospitals effective January 1, 2021. New rates include APR-DRG base rate of $7,505.68, APC conversion factor of $71.76, and updated outlier thresholds for both inpatient and outpatient services.
Action Required
Billing team must update Connecticut Medicaid reimbursement rates in billing system for out-of-state and border hospitals. Update APR-DRG base rate to $7,505.68, behavioral health per diem to $1,050.00, rehabilitation per diem to $1,370.00, and APC conversion factor to $71.76. Reference Provider Bulletin 2020-89 for adjustment factors and APR-DRG weights. Verify hospital-based practitioners are enrolled in professional billing groups per referenced bulletins.