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MedicaidPrior AuthMedium impact

2020.63 Provider Bulletin - Clarification pdf

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Sep 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Prior authorization is no longer required for procedure codes 81420 and 81507 for pregnant HUSKY Health (Connecticut Medicaid) members effective September 1, 2020. These genetic testing services can now be provided to any pregnant member regardless of risk category as long as medically necessary.

Action Required

Action needed
Immediately: Billing team must update system settings to remove prior authorization requirements for CPT codes 81420 and 81507 for pregnant HUSKY Health members. Update encounter forms and workflows to reflect no prior auth needed. Ensure providers document medical necessity per Connecticut Medical Assistance Program requirements.

Affected Billing Codes

81420
81507