MedicaidAdministrativeMedium impact
Billing of Non-Hospital Grade Breast Pumps pdf
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN·Provider Bulletin
We identified it
Jun 20, 2026
Summary
This policy clarifies billing timing for non-hospital grade breast pumps (codes E0602 and E0603), which can be billed during the 3rd trimester before delivery, while hospital grade pumps (E0604) are billed after hospital discharge. Providers must verify no breast pump was billed for the member in the previous 24 months before submitting claims.
Action Required
Immediately: DME billing staff must verify breast pump eligibility by checking the 24-month lookback period through the ctdssmap.com portal under Claims > Claim History for Specific Services > DME-Rent to Purchase before billing E0602/E0603 in 3rd trimester or E0604 post-discharge. Update billing workflows to include this verification step to prevent claim denials.