MedicaidBilling CodesMedium impact
Clarifying the Guidance for Electronic Consultations Performed by Federally Qualified Health Centers pdf
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
We identified it
Jun 20, 2026
Summary
This bulletin clarifies that Federally Qualified Health Centers (FQHCs) in Connecticut can bill for electronic consultations using CPT 99452 when spending 16-30 minutes preparing for or communicating with specialists. FQHCs must submit a change-in-scope application with estimated e-consult volumes to DSS for rate adjustment.
Action Required
FQHC billing teams must: 1) Submit change-in-scope application to Connecticut DSS with 12-month e-consult volume estimates before implementing e-consult billing, 2) Update billing system to include CPT 99452 with HCPCS T1015 for e-consults with eligible specialists, 3) Ensure providers document 16-30 minutes spent on e-consult activities and limit billing to once per 14-day period per patient per specialty, 4) Maintain documentation including medical reasoning, specialist conclusions, and treatment recommendations per state regulations.