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MedicaidBilling CodesMedium impact

Updating the Tuberculosis Limited Benefit pdf

Connecticut Medicaid (HUSKY Health)·CT · Infectious Disease, Pulmonology, Family Medicine +1 more·Provider Bulletin
Effective date
Jun 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid updated billing guidance for Tuberculosis Limited Benefit program, adding new HCPCS codes G0493 and G0494 for Direct Observed Therapy (DOT) services by licensed and registered nurses. The policy requires TB diagnosis codes as primary diagnosis on all TB-related claims and outlines specific billing procedures for different provider types.

Action Required

Action needed
Effective June 1, 2019: Billing teams serving Connecticut Medicaid TB patients must add HCPCS codes G0493 and G0494 to fee schedules for Direct Observed Therapy services. Update billing system to require TB diagnosis codes as primary diagnosis for all TB-related claims. Home health agencies must bill DOT services separately from other services and cannot bill DOT on same day as skilled nursing or medication administration visits.

Affected Billing Codes

G0493
G0494