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MedicaidReimbursementHigh impact

MEDS Fee Schedule Changes pdf

Connecticut Medicaid (HUSKY Health)·CT · Orthopedics, PM&R (Physical Medicine & Rehab), General Practice +1 more·Reimbursement
Effective date
Nov 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid significantly reduced reimbursement rates for several durable medical equipment codes (A6198 reduced by 83%, wheelchair accessories reduced 24-28%) and added prior authorization requirements for custom ankle-foot orthoses. Quantity limits were also implemented for lancets and blood pressure monitors.

Action Required

Action needed
By November 1, 2019: Billing team must update fee schedules for affected DME codes with new reduced rates. Configure billing system to require prior authorization for L1960 and L1970 custom AFO codes. Set quantity limits for A4259 (2 boxes/month), A4660 and A4670 (1 per 3 years). Update encounter forms to alert providers about PA requirements and suggest prefabricated alternatives (L1930, L1971). Download updated fee schedules from www.ctdssmap.com.

Affected Billing Codes

A6198
E1028
E2620
K0040
L1960
L1970
L1930
L1971
A4259
A4660
A4670