Back to dashboard
MedicaidBilling CodesMedium impact

Updated Coding Guidelines for the Behavioral/Developmental Component of Multi- Disciplinary Examinations pdf

Connecticut Medicaid (HUSKY Health)·CT · Psychiatry, Pediatrics·Coding
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid updated coding guidelines for behavioral/developmental components of Multi-Disciplinary Examinations (MDEs) for children in DCF custody, replacing outdated psychological testing codes with new HIPAA-compliant codes effective January 1, 2019. Key changes include ending codes 96101 and 96118, introducing new codes like 96130/96131 for psychological testing, and requiring modifier TF for neuropsychological services.

Action Required

Action needed
Immediately: Billing team must update Connecticut Medicaid claims to use new psychological testing codes - replace 96101 with 96130/96131, replace 96118 with 96132/96133, and append modifier TF to codes 96136 and 96137 for neuropsychological services. Update billing system rules and ensure staff use only the new code set for MDE behavioral/developmental components. Contact Beacon Health Options at 1-877-552-8247 for behavioral health authorization requirements.

Affected Billing Codes

96101
96118
96130
96131
96136
96137
96116
96121
96132
96133
90791
90792
T1015