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Update Regarding New Ordering - Referring - Rendering Edits pdf

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Aug 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid has corrected an error that excluded residents from ordering/prescribing DME equipment. Residents are now retroactively added as valid provider types, and DME providers must resubmit claims that were denied with EOB code 0563 when a resident was the ordering provider.

Action Required

Action needed
Immediately: DME providers must identify and resubmit any claims that denied with EOB code 0563 (Ordering provider type/specialty not valid for billing provider) where the ordering provider was a resident. Review Chapter 12 of the Provider Manual at www.ctdssmap.com for guidance on resolving ordering/referring/rendering edit denials.