Back to dashboard
MedicaidReimbursementMedium impact

Corrected Bulletin - Rates for Rental Items Used with Continuous Positive Airway Pressure (CPAP) and Respiratory Assist Devices, bi-level pressure (BiPAP) pdf

Connecticut Medicaid (HUSKY Health)·CT · Pulmonology, Sleep Medicine·Reimbursement
Effective date
Aug 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid corrected reimbursement rates for CPAP/BiPAP supply codes and now allows separate billing of PAP supplies during equipment rental periods. Key correction: E0562 rental rate is $13.28, not $24.32 as originally published.

Action Required

Action needed
Immediately: Update billing system with corrected reimbursement rates for all listed PAP supply codes. Configure system to allow separate billing of PAP supplies during rental periods for Connecticut Medicaid patients. Set monthly limit of 1 per 3 months for A7027. Remove repair modifier (RB) for codes A7027, E0561, and E0562. Claims will automatically reprocess and appear on October 23, 2018 Remittance Advice.

Affected Billing Codes

A4604
A7027
A7028
A7029
A7030
A7031
A7032
A7033
A7034
A7035
A7036
A7037
A7038
A7039
A7044
A7045
A7046
E0561
E0562