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MedicaidReimbursementMedium impact

Hospital Monthly Important Message - 10.08.2019 pdf

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid has updated payment rates for LARC devices effective October 1, 2019, with Liletta increasing to $934.82 and Etonogestrel implant to $749.40. Multiple system updates are scheduled including new ICD-10 codes causing potential claim suspensions until November when the 3M Grouper is updated.

Action Required

Action needed
Immediately: Update billing system with new Connecticut Medicaid rates for Liletta ($934.82) and Etonogestrel implant ($749.40) effective October 1, 2019. Expect potential claim suspensions for inpatient DRG claims with dates of service October 1, 2019 and forward until 3M Grouper update in November - no action needed as claims will auto-recycle. For delivery stays, ensure primary diagnosis codes are childbirth-specific rather than trimester codes to avoid prior authorization denials.

Affected Billing Codes

90378
O10.013
O10.02