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MedicaidPrior AuthMedium impact

2020.63 Provider Bulletin Removal of PA from CPT Codes 81420 & 81507 pdf

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

Summary

Connecticut Medicaid is removing prior authorization requirements for CPT codes 81420 and 81507 (noninvasive prenatal testing/screening) for all HUSKY Health members effective September 1, 2020. These codes can now be billed without obtaining prior authorization.

Action Required

Action needed
Effective September 1, 2020: Billing team must update system settings to remove prior authorization requirements for CPT codes 81420 and 81507 when billing Connecticut Medicaid (HUSKY Health A, B, C, and D). Update billing workflows and staff training to reflect that these prenatal screening codes no longer require PA. Ensure services are still medically necessary and ordered by CMAP enrolled practitioners.

Affected Billing Codes

81420
81507