MedicaidBilling CodesMedium impact
Hospital Monthly Important Message - 02.12.2019 pdf
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry, Physical Therapy, OB-GYN +2 more·Provider Bulletin
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) updated payment rates, procedure codes, and prior authorization requirements effective January 1, 2019. Key changes include new autism spectrum disorder CPT codes, increased LARC device reimbursement rates, new prior authorization requirements for specific cancer treatments, and updated DRG weights and outlier thresholds.
Action Required
Immediately: Update billing system to use new CPT codes 90791-U5 (replacing 0359T) and 97158 (replacing 0372T) for autism spectrum disorder services. Add prior authorization requirements for procedure codes Q2040, 77046-77047, C8903, C8905-C8906, and C8908. Update Liletta LARC device reimbursement rate to $684.38. Verify all outpatient therapy claims use correct flat fee rates under HUSKY Plus benefit plan. Claims using outdated codes or missing prior authorization will be denied.