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Psychiatric Diagnostic Evaluations Performed in the Emergency Department pdf
Connecticut Medicaid (HUSKY Health)·CT · Psychiatry, Emergency Medicine·Provider Bulletin
Effective date
Dec 1, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid will no longer reimburse outpatient hospitals for psychiatric diagnostic evaluations (CPT 90791 and 90792) performed in emergency departments, effective December 1, 2018. These services must now be billed directly by the individual professionals (physicians, psychologists, behavioral health clinicians) who perform them in the ED setting.
Action Required
Effective December 1, 2018: Hospital billing departments must stop billing CPT codes 90791 and 90792 when psychiatric evaluations are performed in the emergency department (POS 23). Individual professionals (physicians, psychologists, behavioral health clinicians) must bill these codes directly for ED services. Update billing system rules to prevent hospital billing of these codes in POS 23. Failure to comply may result in post-payment adjustments and recoupment by DSS.