MedicaidAdministrativeHigh impact
Hospital Monthly Important Message Updated pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) has implemented multiple system updates effective January 1, 2020, including new HCPCS codes, increased outlier thresholds from $4,825 to $5,075, updated DRG weights and payment rates, and discontinued modifier GD for medically unlikely edits.
Action Required
Immediately: Billing team must stop using modifier GD for medically unlikely edits as it has been discontinued. Update billing system to reflect new outlier threshold of $5,075 (increased from $4,825). Download updated hospital outpatient flat fee schedules from www.ctdssmap.com. Review and process any suspended claims with EOB codes 8182 or 8185 that appear on remittance advice. Update prior authorization processes for HUSKY Plus members when their eligibility changes.