MedicaidPrior AuthMedium impact
Removal of Prior Authorization for Procedure Codes 81528 and 81511 pdf
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Gastroenterology, Oncology·Prior Authorization
Effective date
Aug 1, 2020
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is removing prior authorization requirements for two procedure codes effective August 1, 2020: CPT 81528 (Cologuard colorectal screening) and CPT 81511 (fetal congenital abnormalities testing). These procedures can now be performed without obtaining prior approval.
Action Required
Immediately: Billing team must update system settings to remove prior authorization requirements for CPT codes 81528 and 81511 for Connecticut Medicaid patients. Update encounter forms and billing workflows to reflect that these procedures no longer require pre-approval. Verify changes by accessing the updated Independent Laboratory fee schedule at www.ctdssmap.com.